兔脑脊液经嗅觉通路回流到淋巴系统的形态学观察  

The morphology of olfactory route for cerebrospinal fluid drainage into the peripheral lymphatic system in rabbit

作　　者：刘海生[1] 王东[1] 陈业涛[1] 刘勇刚[2] 齐岩[2] 李妍[1] 孙朝晖[1] 张秋航[2] 王世杰[1] 左焕琮[1] 

机构地区：[1]清华大学玉泉医院神经外科,北京100049 [2]首都医科大学宣武医院耳鼻喉-头颈外科

出　　处：《中华神经外科杂志》2009年第6期564-567,共4页Chinese Journal of Neurosurgery

基　　金：国家自然科学基金（30700858）;北京市首都医学展基金（2005-1035）：感谢北京大学医学部杨蕾副主任技师在病理切片制作中的帮助.

摘　　要：目的在形态学上证实兔颅底蛛网膜下腔经嗅觉通路与颈部淋巴系统相通，脑脊液经此途径回流到淋巴系统。方法采用在兔枕大池内注射Microfil的方法，在大体和光镜下观察灌注物质的分布。结果显微镜下观察见Microfil在枕大池、矢状窦、嗅球、筛板区域聚集分布，穿过筛板，使嗅黏膜淋巴管明显染色呈黄色，并经鼻咽部淋巴管回流到双侧颈浅和颈深淋巴管；光镜下见Microfil沿嗅神经走行，广泛分布在嗅黏膜的淋巴管内。结论在脑脊液与颈部淋巴系统之间存在有经颅底-筛板-嗅黏膜的嗅觉通路的解剖回流途径，对于中枢神经系统免疫性疾病、脑脊液循环的调节有重要意义。Objective To demonstrate the morphology of drainage of the cerebrospinal fluid through the oifactory nerves into the cervical lymphatics. Methods Microfil was injected into the cisterna magMa of the rabbit, cervical lymphatics, the olfactory bulbs, olfactory tracts and the nasal mucosa were observed by macroscopic anatomy and light microscopy. Results Under the operative microscope, Microfil was found within the subarachnoid space and along the olfactory nerves. At the nasal mucosa, a lymphatic network stained in yellow was identified near the olfactory nerves, which cross nasopharyngeal region and finally emptied into the superficial and deep cervical lymph nodes. Light microscopically, Microfil was distributed around the olfactory nerves and within the lymphatic vessels. At the nasal mucosa, the lymphatics were frequently located close to the nerves. Conclusion These results indicate that the cerebrospinal fluid drains from the subarachnoid space along the olfactory nerves to the nasal Lymphatics, which in turn, empties into the cervical lymph nodes. This anatomical communication, thus, allows the central nervous system to connect with the lymphatic system. The presence of this route may play an important role in immune disease of the central nervous system and regulation of the cerebrospinal fluid circulation.

关 键 词：淋巴 脑脊液 蛛网膜下腔 中枢神经系统 

分 类 号：R686[医药卫生—骨科学]