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目的:研究视神经和视交叉的局部解剖及其临床意义。方法:在手术显微镜下观测15个尸颅视神经和视交叉的形态特征及毗邻关系。结果:镰状皱壁沿视神经的长度为0.4～4.6mm,厚度为0.1～0.8mm。1/3的视神经因眼动脉或颈内动脉的上凸而隆突,鞍结节均较平坦,多数视交叉后缘位于鞍背后方。视神经主要由垂体上前动脉供血,半数有分支沿视神经前行。视交叉的上面多由前交通动脉复合体供血,下面的内侧部多为垂体上动脉供血,外侧部多为颈内动脉和后交通动脉的分支供血。视神经上面覆有一层视神经上膜,再上面为直回下面软膜,二膜间多数分开。结论:眼动脉和颈内动脉可凸入视神经.致视力、视野改变。由于国人鞍结节边界不易确定,按传统方法将视交叉分型有困难,所以宜按蝶棱与视交叉前缘间距判断前置或后置。手术中若损伤沿视神经行走的小动脉,电凝须特别小心。贴视神经上抬直回时,实际上是沿视神经与视神经上膜间或沿上膜与直回下面软膜间粘着较少的界面分离,有半数需切断界面间的纤维小粱。
Objective: To study the local anatomy of optic nerve and optic chiasm and its clinical significance. Methods: Morphological characteristics and adjacent relations of optic nerve and optic chiasm were observed under 15 surgical microscopes. Results: The length of falciform crimson along optic nerve was 0.4 ~ 4.6mm and the thickness was 0.1 ~ 0.8mm. 1/3 of the optic nerve due to the ophthalmic or internal carotid artery bulge and convex, saddle nodules are more flat, most of the posterior edge of the optic chiasm in the saddle behind. The optic nerve is mainly supplied by the pituitary anterior artery, and half of the optic nerve branches along the optic nerve. Most of the optic chiasm by the anterior communicating artery complex blood supply, the following medial pituitary artery mostly for the supply of blood, the lateral part of the internal carotid artery and posterior communicating artery for the majority of blood supply. The top of the optic nerve is covered with a layer of optic nerve on the membrane, then the soft membrane above the straight back, most of the two membranes separated. Conclusion: The ophthalmic artery and internal carotid artery can protrude into the optic nerve, resulting in visual acuity and visual field changes. As people sad nodule boundary is not easy to determine, according to the traditional method of visual cross-classification difficulties, it is appropriate according to the edge of the disc and the front of the optic chiasm to determine the front or rear. Surgery, if injured along the optic nerve walking arterioles, special care must be taken. Posterior optic nerve uplift straight back, in fact, is along the optic nerve and optic nerve between the membrane or along the film and back straight below the soft film adhesion less interface separation, there are half required to cut off the interface between the fiber sorghum.