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目的观察视神经管的解剖结构以及视神经管磨除前后相关结构显露范围的变化。方法15例成人干颅骨和15例无颅眶疾病、经甲醛固定的国人尸头,在放大5~25倍的手术显微镜下观察测量。结果视神经管最狭窄的部位是中部,横截面积为(17.21±3.74)mm2。眼动脉均在视神经下方的管底硬膜层内走行。视神经管上壁磨除前视神经颈内动脉三角(OCT)宽度为(3.61±1.35)mm,磨除后为(7.16±1.42)mm。结论视神经管在管中部对视神经的束缚作用最强。打开视神经管上壁及视神经硬膜鞘后,向内侧轻轻地牵拉可移动的视神经,在OCT的宽度方面能增加接近2倍。眼动脉均在视神经下方的管底硬膜层内走行,因而沿视神经纵行剪开其上方的硬膜是安全的。
Objective To observe the anatomic structure of the optic canal and the changes of the exposed areas of the related structures before and after the optic canal ablation. Methods Fifteen adult dry skulls and 15 non-cranial orbital diseases were examined by formalin-fixed cadaveric heads under 5-25 times magnification under a surgical microscope. Results The narrowest part of the optic canal was the middle part with a cross-sectional area of (17.21 ± 3.74) mm2. The ophthalmic arteries are in the bottom of the optic nerve at the bottom of the dura mater. The width of anteroseptal internal carotid artery (OCT) was (3.61 ± 1.35) mm and (7.16 ± 1.42) mm after ablation. Conclusion The optic canal in the middle of the tube has the strongest effect on the optic nerve. After opening the optic canal upper wall and the optic nerve dural sheath, gently pulling the movable optic nerve medially, nearly doubled the width of the OCT. The ophthalmic arteries run within the dura mater of the bottom of the optic nerve and thus it is safe to cut the dural above it along the optic nerve longitudinal.