经鼻外筛蝶窦视神经管减压术的应用解剖学

Anatomy of trans-sphenoethmoidal optic canal decompression

目的:为了更好地开展经鼻外筛蝶窦进路行视神经管减压术。方法:在160侧云南地区成人颅骨标本上,对鼻外筛蝶窦进路行视神经管减压术的主要标志点间的距离和重要形态进行了测量和观察。结果:Dacryon点到筛前孔、筛后孔和视神经管眶口内侧壁中点之间的距离分别为16.4mm、27.69mm、35.52mm,视神经管眶口、颅口的横径和纵径分别为3.98mm、4.64mm、4.85mm、4.08mm;视神经管内壁的长度为9.64mm。观察了视神经管内侧壁与最后组筛突、蝶窦外侧壁和同时与筛蝶窦外侧壁毗邻的机率分别为36.9%、29.4%、33.7%;同时,将视神经管隆突的形态分为管型、半管型、压迹型和平坦型,其出现率分别为3.1%、16.9%、50%和30%。结论:上述数据为经鼻外筛蝶窦进路行视神经管减压术提供了较确切的参考依据,有利于提高手术的疗效和减少并发症。

Purpose: To improve the surgical techniques and skills of trans-sphenoeth-moidal optic nerve canal decompression. Methods: In 160 cases of adult skulls from Yunnan, we observe and measure the major land marks in trans-sphenoeth-moidal optic nerve canal decompression. Results: The distance from Dacryon point to the anterior and posterior ethmoid sinus foramen and the middle point of medium border pf the optic canal are 16.4 mm、 27.69mm and 35.52mm respectively. The mean diameter and transverse diameter of the orbital and cranial orifices of the canal are 3.98mm、 4.46mm, 4.85mm and 4.08mm. The interior walls length of the canal is 9.64mm . After survey, we found that the interior wall of the canal can neighbour the lateral wall of posterior ethmoid sinus、 sphenoid sinus or spheno-ethmoidal sinus, and the incidences are 36.9%, 29.4% and 33.7%. We also divide the shape of the optical canal prominence into tubular、 semi-tubular、 notch and level, the incidences are 3.1%, 16.9%, 50% and 30% respectively. Conclusions: These data provide useful guide for trans-sphenoethmoidal optic canal decompression, and can be helpful in improving surgical techniques and skills.