鼻内镜视神经管减压术相关应用解剖

目的：为鼻内镜视神经管减压术的临床应用提供解剖学依据。方法：随机选取15个外观无异常的经10％福尔马林固定的国人成人尸头，依经鼻内窥镜下视神经管减压术手术路径相同的体位和路径，逐层解剖，观察视神经管及其相关解剖结构。结果：视神经管内侧壁最长、最薄，视神经管内侧壁全部与同侧筛窦毗邻占43．3％，与同侧筛、蝶窦毗邻占26．7％，与同侧蝶窦毗邻占23．3％，其它毗邻关系占6．7％。在视神经管颅口处，大多数眼动脉位于视神经的内下方，到了眶口，多数眼动脉绕行至视神经的外下方。结论：视神经管减压术应打开其内壁，术中应注意该壁复杂的毗邻关系。确定视神经管隆突和颈内动脉隆突，并了解眼动脉在管内的走形特点非常重要。

APPLIED ANATOMY STUDY OF TRANSNASAL ENDOSCOPIC OPTIC CANAL DECOMPRESSION

Objective：To provid transnasal endoscopic optic canal decompression with the anatomic reference. Methods：15 adult cadaverie heads without any lesion were selected at random （ male 9, female 6 ） , we cut these heads along the midsagittal plane, whose brain tissues were removed subsequently. According to the approach optic canal decompression of transnasal endoscopic operation, We measured the of the optic canal and its relative. Results ： The medial wall of opticcanal is the most longest and weakest. The medial wall of optic canal all being close to ethmoid sinus of the same side was 43.3 % , and close to ethmoid sinus , sphenoid sinus of the same side was 26.7% , and close to sphenoid sinus of the same side was 23.3% , others were 6.7%. At the cranial end,63.3% ophthalmic arterys were located on the inferior medial side of the optic nerve and about 80.0% ophthalmic arterys rotated to the inferior lateral side at the orbital end. Conclusion：It is important to unfold this wall in the optic canal decompression and the complex syntopy of this wall should be paid attention to. It is very svery important to befine optic canal dulge and carotid atterydulge andto understand ophthalmic artery position feature in optic canal.