颅眶区结构的显微解剖学研究  

Microanatomical study on the structure of the cranioorbital region

作　　者：程进超 王其福 王伟功 李陈 荣军 李廷政 宣浩 江晓春[2,3] Cheng Jinchao;Wang Qifu;Wang Weigong;Li Chen;Rong Jun;Li Tingzheng;Xuan Hao;Jiang Xiaochun(Department of Neurosurgery,Xuancheng Central Hospital,Xuancheng 242000,China;Translational Research Institute for Neurological Disorders,Wannan Medical College,Wuhu 241000,China;Department of Neurosurgery,the First Affiliated Hospital of Wannan Medical College(Yijishan Hospital),Wuhu 241000,China)

机构地区：[1]宣城市中心医院神经外科,宣城242000 [2]皖南医学院神经系统疾病转化医学中心,芜湖241000 [3]皖南医学院第一附属医院(弋矶山医院)神经外科,芜湖241000

出　　处：《中华神经外科杂志》2024年第2期176-181,共6页Chinese Journal of Neurosurgery

基　　金：安徽省临床医学研究转化专项项目(20220429510702000013,20220429510702000060);安徽省高校优秀创新团队项目(2022AH010073)。

摘　　要：目的 通过显微解剖研究颅眶区的骨性结构、肌肉、神经及动脉等解剖结构,为该区域的手术提供解剖学依据.方法 选取8具(16侧)成人尸头标本,经额颞眶颧入路行弧形切口逐层显露颅眶区解剖,观察颅眶交界区解剖结构、测量眶上裂相关数据;观察眼眶区的骨性结构、肌肉、神经走行、眼动脉的解剖结构及其位置关系,并测量经眶上裂进入眼眶的神经直径.结果 颅眶交界区位于前床突下方,视神经管沟通颅内与眼眶,眶上裂连接眼眶和中颅窝,8具尸头标本的眶上裂外侧缘、内侧缘、上缘长度分别为(18.4±6.2)mm、(7.7±1.6)mm、(16.4±5.6)mm,左、右侧眶上裂宽度分别为(3.64± 0.86)mm、(3.69±0.88)mm.眶壁由额骨、颧骨、筛骨、泪骨、蝶骨、腭骨和上颌骨7块骨性结构构成;眼眶处存在顶壁、底壁、内侧壁和外侧壁,除内侧壁外,其他各壁的骨性结构呈对称排列.眼眶肌肉由上睑提肌、上斜肌、下斜肌、上直肌、下直肌、内直肌和外直肌7条肌肉构成.眼眶内神经主要由视神经、滑车神经、眼神经的3个分支(额神经、泪腺神经、鼻睫神经)、外展神经、动眼神经(上、下支)共7根神经构成;除视神经由视神经管进入眼眶外,其他6根神经的7个分支均由眶上裂进入眼眶,依上述次序直径分别为(0.86±0.42)mm、(1.51±0.53)mm、(0.71±0.36)mm、(0.82±0.47)mm、(1.23±0.41)mm、(1.29±0.48)mm、(1.82±0.48)mm.眼动脉在视神经下方同视神经一起由视神经管入眶,8具标本中共观察到16支眼动脉,其中1具为双干眼动脉,其上、下干的距离为11.2mm;其余7具均为单干眼动脉,并根据其在眼动脉眶内走行中的眼动脉角和眼动脉弯将眼动脉眶内段依次分为3段.颅眶区的骨性结构、肌肉、神经走行、眼动脉位置关系基本固定.结论 颅眶区域解剖复杂,空间狭小,熟悉该区域显微解剖及其位置关系,有利于临床医生在外科手术中对重要解�ObjectiveTo study the spatial structures among the bony structures,muscles,nerves,and arteries in the cranio-orbital region by microdissection,and to provide anatomical basis for neurosurgery in this area.MethodsA total of 8 adult(16 sides)cadaveric head specimens were selected.The cranio-orbital region was exposed layer by layer using a curved incision via the frontotemporal orbito-zygomatic approach.The anatomical structure of the cranio-orbital junction region was observed and the data related to the supraorbital fissure were documented.The bone structures,muscles,nerve courses ophthalmic arteris anatomy and their position relationship were obserred.The diameters of the nerves entering the orbit through the supraorbital fissure were measured as well.ResultsThe cranio-orbital junction region was located below the anterior clinoid process.The optic canal connected the cranial fossa and the orbit.The supraorbital fissure connected the orbit to the middle cranial fossa.The lengths of lateral,medial,and superior margins of the supraorbital fissure in the eight cadaveric head specimens were 18.4±6.2 mm,7.7±1.6 mm,16.4±5.6 mm respectively.The widths of the supraorbital fissure on the left side and right side were 3.64±0.86 mm and 3.69±0.88 mm respectively.The widths of the left and right supraorbital fissures were 3.64±0.86 mm and 3.69±0.88 mm respectively.The orbital wall consisted of 7 bony structures:frontal bone,zygomatic bone,ethmoid bone,lacrimal bone,pterygoid bone,palatine bone and maxillary bone.The orbit had a roof,a floor,a medial wall and a lateral wall.Except for the medial wall,the other walls had symmetrically arranged bony structures.The extraocular muscles included 7 muscles:levator palpebrae,rectus superioris,rectus inferioris,rectus medialis,rectus externus,obliquus superioris and obliquus inferioris.The intraorbital nerves mainly consisted of 7 nerves:the optic nerve,the trochlear nerve,three branches of the ophthalmic nerve(frontal,lacrimal and nasociliary nerves),the abducens nerve and th

关 键 词：眼眶 视神经 眼动脉 眶上裂 显微解剖 

分 类 号：R651.1[医药卫生—外科学]