嗅相关神经的临床解剖学观测

Clinical anatomy study of olfaction correlative nerves

目的:了解嗅神经的正常走行及其与视神经、鼻窦之间的关系,为临床开展相关手术提供解剖学资 料,并为预防鼻窦手术中嗅神经损伤提供解剖学依据。方法:在16例32侧成人尸头上对嗅神经、嗅束、嗅球进行 解剖测量,并观察其与视神经、鼻窦之间的关系。结果:嗅束的长度为(29.32±2.11)mm,中点处宽度为(3.36± 0.83)mm,嗅束中点内侧距前颅底中线垂直距离为(5.48±1.02)mm,嗅束与矢状线之间夹角为(21.32±3.28)°, 嗅球长度为(10.43±2.35)mm,宽度为(5.12±0.62)mm;84.4%(27/32)的嗅束后端与蝶窦、前中部与筛窦顶相 邻,9.4%(3/32)嗅束仅与筛窦顶相邻,6.3%(2/32)嗅束与额窦顶相邻,所有嗅束都在视神经管内口处与视神经 交叉向前内行走,嗅球前缘与筛泡前缘基本在同一水平。结论:嗅束基本都在眶内侧颅底行走,鼻内手术时应注 意不要损伤鼻窦顶部,术中可以筛泡来定位嗅球位置,结合嗅束与矢状线之间夹角可以大致给嗅束定位,对于防 止手术损伤嗅神经具有一定意义。行前颅底手术上抬大脑额叶时应注意防止拉断嗅丝。

Objective:To find out the relation of the olfactory nerves , the optic nerve, and the nasal sinuses. Provide anatomic data for not to damnify olfactory nerves in the surgery.Method:To measure the olfactory nerves,the olfactory bulb, and olfactory tract on 16 adult cadaveric specimens,and observe the relation of the olfactory nerves,the optic nerve,and the nasal sinuses.Result:Length of the olfactory tract was(29.32±2.11)mm,width of the olfactory tract was(3.36±0.83)mm.The distance from the midpoint of the olfactory tract to the midline of the skull was(5.48±1.02)mm.The angle between olfactory tract and midline of the skull was(21.32±3.28)°.Length of the olfactory bulb was(10.43±2.35)mm,width of the olfactory bulb was(5.12±0.62)mm. 27/32 olfactory tracts were border upon with sphenoid sinus and ethmoid sinus, 3/32 olfactory tracts were border upon with ethmoid sinus,2/32 olfactory tracts were border upon with frontal sinus. All olfactory tracts crossed the optic nerve at the internal meatus of optic nerve canal. The olfactory bulb and ethmoid bulb were on equal line.Conclusion:Almost all olfactory tracts were lied in the inboard of the orbital cavity, protect the roof of the nasal sinus to avoid damnify the olfactory nerves. It is easy to pull out the olfactory nerves when raising the cerebra in the operation of anterior cranial fossae.