鼻内镜下视神经管的局部解剖与临床应用

Applied anatomy study of optic canal by transnasal endoscopy

目的:为鼻内镜下视神经管减压术的临床运用提供解剖学依据。方法:成人尸头湿性标本15例(30侧)视神经管,经鼻内镜下观察视神经管的局部解剖情况。结果:鼻内镜下测得前鼻棘到视神经管眶口内侧壁中点距离为(61.02±5.83)mm,前鼻棘到视神经管眶口内侧壁中点的角度为(45.1±4.81)°,视神经管的内侧壁最长,平均为(11.61±1.58)mm;视神经管外侧壁骨质最厚,内侧壁骨质最薄,内侧壁中又以眶口最厚。并且将观察所见应用于10例外伤性失明患者,效果满意。结论:鼻内镜下了解视神经管的局部解剖情况,对临床开展鼻内镜下视神经管减压术具有非常重要的意义。鼻内镜下视神经管减压术具有手术范围小,组织损伤轻,视野清晰,进路直接,术后处理简单,面部不留瘢痕等优点,值得临床推广应用。

Objective：To provide transnasal endoscopic optic canal decompression with the anatomic reference. Method： 15 samples of the adult corpse wet specimen （30 sides for the optic canal）were examined under the endoscope to scrutinize the regional anatomy of the optic canal. Result： distance between the spina nasalis anterior and the midpoint of optic canal medial wall is （61.02±5.83） mm, and the angle between spina nasalis anterior and he midpoint of optic canal medial wall is （45.1±4.81）°. The medial wall of optic canal is longest ,with an average length of （11.61 ±1.58）mm; the lateral wall of optic canal is thickest, and the medial wall thinnest. 10 traumatic blind patient underwent endoscopic optic canal decompression with satisfactory outcome. Conclusion： The regional anatomy of the optic canal under endoscope is of importance to endoscopic optic canal decompression. Which is microinvasive with direct approach and clear view thus is widely used in clinical practice.