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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 understand the normal walking of the olfactory nerve and its relationship with optic nerve and sinus, to provide anatomical data for the clinical operation, and to provide anatomical evidence for the prevention of olfactory nerve injury in sinus surgery. Methods: Anatomical measurements of olfactory nerve, olfactory tract and olfactory bulb were performed on 16 adult cadaveric heads of 32 adults and their relationship with the optic nerve and sinuses were observed. Results: The length of the olfactory bundle was (29.32 ± 2.11) mm and the width at the middle point was (3.36 ± 0.83) mm. The vertical distance between the medial side of the olfactory bundle and the midline of the anterior skull was (5.48 ± 1.02) mm. (21.32 ± 3.28) °, length of olfactory bulb (10.43 ± 2.35) mm, width (5.12 ± 0.62) mm; 84.4% (27/32) The middle part was adjacent to the ethmoid sinus. 9.4% (3/32) of the olfactory tract was only adjacent to the ethmoid sinus, and 6.3% (2/32) of the olfactory tract was adjacent to the frontal sinus. Crossing forward with the optic nerve, the anterior edge of the olfactory bulb and the front of the basic bubble at the same level. CONCLUSIONS: Olfactory tracts basically walk in the orbital base of the skull. During the intranasal surgery, the top of the sinuses should be not damaged. The position of the olfactory bulb can be located by using the foam screen during operation. The angle between the olfactory tract and the sagittal line can be roughly equal to that of the olfactory tract Positioning for the prevention of surgery to damage the olfactory nerve has some significance. Anterior cranial skull surgery to lift the frontal lobes should be taken to prevent rupture of sniffing silk.