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目的通过研究对视神经管和眼眶的解剖研究,为内镜经鼻入路视神经管减压和治疗眼眶内病变提供解剖基础。方法国人尸头5例,采用大体解剖和内镜下经鼻入路两种方法,观察重要的解剖标志;使用内直肌内移技术,观察视神经管和眼眶内结构的暴露情况以及重要结构的位置、毗邻、走行等。结果钩突位于中鼻甲的前下方;筛泡在钩突的后方,切开筛泡可进入筛窦;筛前后动脉是筛窦内的重要解剖标志;视神经管隆突、颈内动脉隆突和视神经管颈内动脉隆突(OCR)是蝶窦内重要的解剖标志;纸样板位于筛窦的外侧壁,切开纸样板可暴露眶内容物;在眶内,可从内直肌与下直肌之间的通路暴露视神经。在本次10侧标本中,9侧眼动脉起自于颈内动脉的床突上段;1侧眼动脉起自于颈内动脉海绵窦段。7侧眼动脉在视神经管内走行于视神经的下外侧;2侧走行于视神经的正下方;1侧走行于视神经的下内侧。结论内镜下经鼻入路可以进行视神经管和眼眶内侧部分的暴露。钩突、筛泡、筛前后动脉及后组筛窦是本入路重要解剖标志。视神经管隆突、颈内动脉隆突及视神经管颈内动脉隆突(OCR)是进行视神经管减压的重要标志。眼动脉及其眼眶内分支、筛前后动脉和颈内动脉是重要的血管结构。眼内直肌内移技术可以有助于暴露眶内解剖结构。
Objective To study the anatomy of the optic canal and orbit and provide anatomic basis for optic canal decompression and intraorbital lesions in endoscopic transnasal approach. Methods Chinese cadaveric head in 5 cases, the use of gross anatomy and endoscopic nasal approach to observe the important anatomical landmarks; the use of endoskeleton internal migration techniques to observe the optic nerve canal and orbital structure of the exposure and the important structure Location, adjacent, walking and so on. Results The uncinate process was located at the anterior and inferior part of the middle turbinate. The sieve bubble was located behind the uncinate process and incised the sieve bubble to enter the ethmoid sinus. The anterior and posterior sieve artery was an important anatomical landmark in the ethmoid sinus. The optic nerve canal, internal carotid artery, The optic nerve internal carotid artery carina (OCR) is an important anatomical landmark of the sphenoid sinus; paper template located in the outer wall of the ethmoid sinus, cut the paper template can be exposed orbital contents; in the orbital, Pathways between the muscles expose the optic nerve. In this 10 side specimens, the 9 side of the ocular artery from the internal carotid artery in the upper part of the bed; 1 side of the ocular artery from the internal carotid artery cavernous sinus. 7 lateral eye artery in the optic canal of the optic nerve in the lower lateral; 2 side of the line in the optic nerve just below; 1 side of the line in the lower part of the optic nerve. Conclusions Endoscopic transnasal approach exposes the optic canal and medial orbital part. Hook, bubble sieve, sieve before and after the ethmoid anterior ethmoid sinus is an important anatomical landmark of this approach. Optic nerve canal carina, carotid artery carotid and optic canal Internal carotid artery carina (OCR) is an important sign of optic canal decompression. Ophthalmic artery and its orbital branch, before and after the sieve artery and internal carotid artery is an important vascular structure. Intraocular rectus femoral shunt technique can help expose the orbital anatomy.