眶尖区显微解剖及断层解剖学研究

Micro-and sectional anatomical study of the orbital apex region

目的研究眶尖区及其穿行结构显微解剖,为临床该区手术及疾病诊断提供显微解剖学资料。方法在肉眼及放大16倍的手术显微镜下,对30例(60侧)成人干性颅骨标本和18例(36侧)成人颅底湿标本的眶尖区进行显微解剖学观测,对成人眶尖区组织结构火棉胶包埋薄层断面观测。结果视神经管各壁长度分别为(mm):上壁8.92±1.79、下壁6.02±1.27、外侧壁7.79±1.64和内侧壁8.56±1.72。视环厚度为0.62mm。在眶尖区断层标本上,测量额神经与滑车神经、展神经与鼻睫神经平视神经管颅口部距离分别为(mm):2.46±0.59、1.96±0.72,眶上裂中央区展神经与视神经管在颅口部的最短距离为(mm):9.32±0.85。结论眶尖区穿行结构复杂,排列紧凑,手术操作须在显微镜下直视进行。眶尖区薄层断面能原位、准确显示眶尖区结构,有助于临床眶尖区疾病的诊断与治疗。

Objective To study microanatomy of orbital apex（OA） region and its adjacent structures, in order to provide anatomical basis for the operation of the OA region. Methods The osseous structures and the structures passing the OA region were examined in adult dry skulls （60 sides） and cadaveric heads （36 sides） under naked eye and microscopy. The serial thin sections of the OA region which embedded with celloidin were observed. Resuits The length of the optic canal, the height and transverse dimension of both opennings, and the thickness of the canal wall were measured. The relationship of adjacent structures of the optic canal was observed. The distance between the frontal and trochlear nerves in the cranial orifice of lateral area was （2.46 ± 0. 59） mm, and the distance between the abducens and nasociliary nerves in the cranial orifice of central area was （ 1.96 ± 0. 72） mm, and the smallest distance between the abducens nerves of the lateral area and the optic canal was （9.32 ± 0. 85） mm in the section of the OA region. Conclusion The issues in this region are fragile, compact, and easy to be injured. It will be good that the operation in this region be fulfilled under microscope. The serial thin section of the OA region has special advantage over other methods in measuring the irregular structure and is helpful for surgical operation in this region.