眶尖结构的临床应用解剖研究

STUDY AND CLINICAL APPLICATION OF THE ORBIT APEX

目的 :为眶尖部病变的诊断与治疗提供解剖参数。方法 :应用 1 8例无肉眼可见病变的成人头颅湿性标本 ,先行CT扫描 ,后制成 0 .5mm厚的切片 ,在放大 1 6倍的手术显微镜下 ,对眶尖部进行显微解剖、观察和测量。结果 :比较分别用CT和体视学法测量视神经管和视神经的体积 ,以及视神经管内侧壁的厚度 ,结果无统计学差异 ;体视学法测得的眶上裂面积和穿经神经的面积之比 ;穿经神经与眶上裂上壁、内侧壁的距离以及各神经间的距离 ;穿经眶上裂中央区的神经与视神经管的最短距离。结论 :体视学法对眶尖部不规则形结构的测量有其独到之处 ;熟悉该部位的显微解剖 ,有助于临床诊断与治疗。

To provide microsurgical anatomical data for diagnosis and treatment of the disease related to the orbit apex. Methods: We examined 18 healthy adult cadaveric heads by CT scanning and operating microscopy. Results: CT and stereology had no statistical difference in measuring the volume of the optic cannal, optic nerve and the thickness of the medial wall of the optic cannal; By using of stereology, the volume ratio between the optic nerves and the optic cannal were measured; The distance between the passing nerves and the superior and medial walls of supraorbital fissure, the distance among the passing nerves and the short distance between the passing nerves and the optic cannal were all measured. Conclusion: Stereology has special advantage over other methods in measuring the irregular structure; When doing surgical operation in orbit apex, we should avoid to impairing the nerves which pass through the superior orbit fissure.