眶上锁孔入路的颅外应用解剖  

Extracranially applied anatomy via the supraorbital keyhole approach

作　　者：林毅兴[1] 史继新[1] 印红霞[1] 陈克非[1] 李首春[1] 王汉东[1] 邱永明[2] 罗其中[2] 

机构地区：[1]南京军区南京总医院暨南京大学医学院临床医学院神经外科,南京210002 [2]上海交通大学医学院附属仁济医院神经外科,上海200001

出　　处：《中华神经医学杂志》2007年第8期791-793,共3页Chinese Journal of Neuromedicine

摘　　要：目的研究眶上锁孔入路(SKA)的颅外应用解剖,减少该入路的手术并发症。方法福尔马林固定成人尸头10例,在SKA范围内解剖眼轮匝肌、面神经颞支的额肌支和眶上神经,测量切口以上眼轮匝肌的高度,额肌支与额骨颧突、眶上孔/切迹与额骨颧突的水平距离,眶上神经外侧支与眶上缘的夹角。结果切口以上眼轮匝肌的高度为(6 94±0.97)mm(4.92～8.30 mm)。面神经颞支的额肌分支与额骨颧突的水平距离为(19.50±3.57)mm(12.72～23.68mm)。眶上孔/切迹与额骨颧突的水平距离为(30.61±1.62)mm(26.42～33.00mm),眶上神经外侧支从眶上孔/切迹发出的10mm范围内均在骨膜外向外上走行,其与眉弓的夹角为(73.96±3.43)°(68.0～80.2°)。结论应用SKA时需注意眼轮匝肌、面神经颞支的额肌分支和眶上神经等颅外结构的保护。Objective To study the extracranially applied anatomy via the supraorbital keyhole approach （SKA） so as to reduce postoperative complications. Methods The orbicularis muscle, frontalis ramus of temporal branch of facial nerve and lateral branch of supraorbital nerve （LSN） in the scope of SKA were studied in 10 adult formalin-fixed cadaveric head specimens. The height of orbicularis muscle above the SKA incision, the horizontal distance between frontalis ramus and zygomatic process of frontal bone, supraorbital foramen/incisure and zygomatic process of frontal bone, and the angle from LSN to the supraorbital arch were measured. Results The height of orbicularis muscle above the incision was （6.94＋0.97） nun （4.92-8.30 mm）; the horizontal distance between frontalis ramus and zygomatic process of frontal bone, supraorbital foramen/incisure and zygomatic process of frontal bonewere （19.50±3.57） mm （12.72-23.68mm） and （30.61±1.62） mm （26.42-33.00mm）, respectively. LSN within 10 nun away from supraorbital foramen/incisure went outward and upward above periosteum, and the angle from LSN to the supraorbital arch was （73.96±3.43）°（68.0-80.2°）. Conclusion Attention should be paid to the protection Of the extracranial structures such as orbicularis muscle, frontalis ramus of temporal branch of facial nerve and supraorbital nerve in surgery using SKA.

关 键 词：眶上锁孔入路 显微解剖 

分 类 号：R322[医药卫生—人体解剖和组织胚胎学]