视神经管及其相关结构的显微外科解剖  

Microsurgical anatomy of the optic canaland its relative structures

作　　者：陶存山[1] 卢亦成[2] 楼美清[2] 王冰心[1] 汪亮[1] 李文[1] 张康[1] 蒋建华[1] 

机构地区：[1]解放军第三五九医院神经外科,镇江212001 [2]第二军医大学附属长征医院神经外科

出　　处：《江苏医药》2005年第10期757-759,F0003,共4页Jiangsu Medical Journal

摘　　要：目的观察视神经管的解剖结构以及视神经管磨除前后相关结构显露范围的变化.方法 15例成人干颅骨和15例无颅眶疾病、经甲醛固定的国人尸头,在放大5～25倍的手术显微镜下观察测量.结果视神经管最狭窄的部位是中部,横截面积为(17.21±3.74) mm2.眼动脉均在视神经下方的管底硬膜层内走行.视神经管上壁磨除前视神经颈内动脉三角(OCT)宽度为(3.61±1.35) mm,磨除后为(7.16±1.42) mm.结论视神经管在管中部对视神经的束缚作用最强.打开视神经管上壁及视神经硬膜鞘后,向内侧轻轻地牵拉可移动的视神经,在OCT的宽度方面能增加接近2倍.眼动脉均在视神经下方的管底硬膜层内走行,因而沿视神经纵行剪开其上方的硬膜是安全的.Objective The anatomic structures of optic canal region were studied in detail, and then the anatomic exposed difference was explored with removel of the optic canal roof or lateral walls. Methods Fifteen dry adult cadaveric head specimens and fifteen Chinese cadaveric speciments fixed in formalin without intracranial and intraorbital disease were utilized to measure the relative structures under magnification 5-25 operative microscope. Results The middle part of the optic canal was the narrowest, with a transverse area of （17.21±3.74） mm^2. Opticocarotid triangle （OCT） was （3. 61 ± 1.35） mm in situ and （7.16±1. 42） mm post-resection of roof of the optic canal. Conclusion There is a narrow portion in the middle of the optic canal. OCT width could be increased doubly by opening the roof of the optic canal and incising dural sheath of optic nerve, with allowable retraction on the mobilized optic nerve medially. Since the ophthalmic artery commonly goes in the dura beneath the optic nerve, it is safe to incise the dura vertically over it.

关 键 词：视神经管 显微解剖 眼动脉 视网膜中央动脉 相关结构 显微外科解剖 显微镜下观察 颈内动脉三角 解剖结构 甲醛固定 

分 类 号：R774.6[医药卫生—眼科] R816.1[医药卫生—临床医学]