视神经管的显微外科解剖学研究  

The Study on Microsurgery Anatomy of Optic Canal

作　　者：杨有雄 廖建春[2] 陆勤康 张建耀 党瑞山[4] 纪荣明[4] 刘环海[2] 王惠云 江涛 严皎娜 曹澄 

机构地区：[1]浙江省宁波市鄞州人民医院耳鼻咽喉科,315040 [2]第二军医大学附属长征医院耳鼻咽喉-头颈外科 [3]浙江省宁波市鄞州人民医院眼科 [4]第二军医大学解剖学教研室

出　　处：《解剖与临床》2007年第1期7-10,共4页Anatomy and Clinics

基　　金：第二军医大学附属长征医院联合攻关项目(2004002)

摘　　要：目的:研究视神经管的显微外科解剖,为视神经管减压术提供解剖学依据。方法:手术显微镜下解剖15例共30侧10%甲醛固定的成人尸头视神经管标本,观测下列参数。(1)视神经管的长度和视神经管各壁及硬膜鞘的厚度;(2)视神经管中轴与颅正中矢状面、颅冠状面的夹角;(3)视神经管及视神经在眶口、管中部、颅口的垂直径、横径,并计算其横截面积;(4)视神经管内侧壁的毗邻结构及视神经与颈内动脉、眼动脉的关系。结果:视神经管的内侧壁最长,平均长度(11.61±1.58)mm;视神经管横截面积在眶口处最大,为(22.05±3.47)mm2;视神经横截面积在颅口处最大,为(10.62±2.34)mm2。结论:(1)视神经管眶口处对视神经的膜性束缚力最大;(2)当打开视神经管骨壁后,鞘膜切开应选择内侧壁内缘稍上方。Objective：To investigate the microsurgery anatomy of optic canal and provide detailed anatomical data for optic canal decompression. Methods： The optic canal was dissected on 15 cases （30 sides） of adult human skulls under operating microscope, the following parameters were evaluated. （1）The length of optic canal and thickness of both the canal wall and dura. （2）The angle formed by the central axis of optic canal and medial saggital plane and coronal plane of the skull.（3）The mean vertical diameters, transverse diameters and transverse areas of optic canal and nerve at orbital opening,middle portion and cranial opening were measured and calculated respectively. （4）The anatomic relationship of the medial wall to its adjoining structures, and relationship between the oqtic nerve and internal carotid artery,ophthalmic artery.Results：The medial wall of the optic canal was the longest, with a length of （11.61 ± 1.58） mm.The cross section area （CSA） of optic canal at orbital opening was biggest,that was （22.05± 3.47） mm^2. the CSA of the optic nerve was biggest at cranial opening, that was （ 10.62 ± 2.34） mm^2. Conclusions： （ 1 ）The strongest constrictive force from dura is at the orbital opening of the optic canal. （2）After the bone wall of the optic canal is removed, the region dura is cut must be a little over the medial part of the medial wall.

关 键 词：视神经管 视神经 视神经管减压术 显微外科解剖学 

分 类 号：R322[医药卫生—人体解剖和组织胚胎学]