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目的探讨动眼神经三角的显微解剖,为术中动眼神经的保护提供解剖参考。方法经血管灌注后观测10例(20侧)尸头的动眼神经三角及其毗邻。结果动眼神经三角由前岩床突韧带、后岩床突韧带、床突间韧带三边构成。动眼神经由动眼神经三角中央处穿入海绵窦,动眼神经入海绵窦处距离颈内动脉床突上段发起处向后2～7mm,平均5mm。其外上方与脉络膜前动脉相邻,内上方与后交通动脉相邻。滑车神经从动眼神经的后外侧进入海绵窦,在海绵窦外侧壁的后方位于动眼神经下方行走。结论动眼神经三角解剖结构毗邻复杂,前岩床突韧带、后岩床突韧带、后床突、颈内动脉床突上段发起处是术中较好的解剖标志。在鞍区、鞍旁、岩尖等手术时应特别辨认和保护动眼神经。
Objective To investigate the microscopic anatomy of oculomotor nerve triangle and provide anatomic reference for the protection of oculomotor nerve during operation. Methods The oculomotor triangle and its adjacency in 10 cases (20 sides) cadaveric head were observed after perfused with blood vessel. Results The oculomotor triangle consists of a former petrous ligament, a posterior petrous ligament, and an intercostal ligament. The oculomotor nerve penetrates the cavernous sinus through the central oculomotor triangle, and the oculomotor nerve enters the cavernous sinus at a distance of 2 mm to 7 mm from the origin of the upper segment of the internal carotid artery. The outer upper part is adjacent to the anterior choroidal artery and the upper part is adjacent to the posterior communicating artery. The trochlear nerve enters the cavernous sinus from the posterolateral side of the oculomotor nerve and is located under the oculomotor nerve behind the lateral wall of the cavernous sinus. Conclusions The triangular ocular anatomy of the oculomotor nerve is adjacent to the complex anatomic structure of the anterior segment of the supraspinatus ligament, the posterior suture ligament, the posterior bed bump and the internal carotid artery. In the saddle area, saddle side, rock tip and other surgery should be particularly identify and protect the oculomotor nerve.