内镜经眶上锁孔入路视神经管减压的解剖学研究  

Anatomic study of endoscopic optic nerve decompression through supraorbital keyhole approach

作　　者：王晓东 张恒柱 严正村 吴巍 兰青[2] Wang Xiaodong;Zhang Hengzhu;Yah Zhengcun;Wu Wei;Lan Qing(Department of Neurosurgery, Clinical Medical College of Yangzhou University, Yangzhou, Jiangsu 225001, China;Neurosurgery, The Second Affiliated Hospital of Soochow University, Suzhou, Jiangsu 215002, China)

机构地区：[1]扬州大学临床医学院神经外科,225001 [2]苏州大学附属第二医院神经外科,215002

出　　处：《中国微侵袭神经外科杂志》2018年第2期85-87,共3页Chinese Journal of Minimally Invasive Neurosurgery

基　　金：扬州市重点研发项目(编号:YZ2015046)

摘　　要：目的在尸头标本上,探讨经眶上锁孔硬膜外入路行神经内镜下视神经管减压术的可行性。方法以直径4 mm的0°和30°硬质神经内镜对10例(共20侧)成人尸头标本,行眶上锁孔硬膜外视神经管减压术,记录入路相关解剖结构并测量相关数据。结果通过眶上锁孔硬膜外入路,神经内镜可清晰显露蝶骨嵴、前床突、视神经管内口与镰状韧带,并完成对视神经管外壁及上壁的磨除减压。经测量,额骨颧突至视神经管内口距离为(59.32±2.27)mm,视神经管内口上壁中点至颈内动脉距离为(3.80±0.93)mm。结论神经内镜经眶上锁孔硬膜外入路可对视神经管上壁与外侧壁进行充分减压,具有安全、微创与有效的特点。Objective To evaluate the feasibility of endoscopic decompression of optic nerve through a supraorbital keyhole approach in cadavers. Methods The cadaveric heads of 10 adult（20 sides） were studied. The optic nerve decompression was performed by 4 mm,0° and 30° rigid endoscopes through the supraorbital keyhole extradural approach. The relevant measurements about the optic canal were recorded. Results The sphenoid ridge, the anterior clinoid process, the roof of the optic canal and the falciform ligament were clearly exposed by endoscope through the supraorbital keyhole extradural approach. The roof and lateral wall of the optic canal were removed and decompressed by endoscope. The distance from the zygomatic process of the frontal bone to the optic canal internal opening was（59.32 ± 2.27） mm, the distance from the midpoint on the superior wall of the internal opening of the optic canal to the internal carotid artery was（3.80 ± 0.93） mm. Conclusions Neuroendoscope can be used to perform full decompression of the superior and lateral walls of the optic canal through the supraorbital keyhole extradural approach and is minimally invasive, safe and effective for optic nerve decompression.

关 键 词：减压术 视神经管 入路 眶上锁孔 神经内镜 

分 类 号：R322.8[医药卫生—人体解剖和组织胚胎学]