视神经管内结构的显微外科解剖及临床意义  被引量:13

Microsurgical anatomy of the intracanalicular structures of the optic canal and its clinical significance

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作  者:陶海[1,2] 马志中[1,2] 姜荔[1,2] 

机构地区:[1]中国人民解放军总医院眼科 [2]空军吉林医院眼科

出  处:《中华显微外科杂志》1999年第3期207-209,共3页Chinese Journal of Microsurgery

基  金:军队"九五"医药卫生科研重点项目基金

摘  要:目的为视神经减压术和进一步探索视神经间接损伤的病理机制提供形态学依据。方法30个成人尸头的60侧视神经管在手术显微镜下进行了解剖观测。测量了管内段视神经的口径,计算了视神经的横截面积。测量了管内段视神经硬膜鞘各壁的厚度,观察了管内各结构之间的位置关系。结果从视神经管颅端到眶端,硬膜鞘的鞘壁逐渐增厚,在眶口处,硬膜鞘形成一个明显增厚的“环”围绕视神经;管内三层脑膜紧密粘连的部位和范围是多样的。在视神经管颅口处,大多数眼动脉位于视神经的内下方,到了眶口,多数眼动脉绕行至视神经的外下方。结论视神经间接损伤后,硬膜鞘在眶端处对视神经的束缚作用可能最强。蛛网膜下腔沟通颅内和眶内的脑脊液循环的形式是多样的。由于管内段视神经被牢固地固定于视神经管内,在外力作用下,管内段视神经能承受位移的潜力很有限。Objective To provide detailed morphological knowledge for optic nerve decompression and farther understanding on the pathologic mechanisms of indirect optic nerve injury Methods Sixty optic canals in the 30 fixed human cadaver heads were observed and measured under the operating microscope The calibers of intracanalicular optic nerve,the thickness of dura were measured,the optic nerve transverse area were calculated The detailed anatomic relations among these structures were carefully identified Results From the cranial end to orbital end of optic canal,the thickness of the dura gradually increases,at the orbital portion,a ring of membrane which around the optic nerve was formed The locations and the area that three meninges firmly attach to each other was varied At the cranial end,the ophthalmic artery was located mainly on the inferior medial side and rotated to the inferior lateral side at the orbital end Conclusions In the orbital end,the restraining of the dural sheath on the injured optic nerve may be the most powerful The communication patterns varied between orbit and cranial cavity via subarachoid space Due to the optic nerve was firmly fixed in the optic canal and its dural sheath,the potential for the optic nerves moving was limited while being injuried

关 键 词:视神经 显微外科 解剖 管内结构 

分 类 号:R322.8[医药卫生—人体解剖和组织胚胎学]

 

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