眶部经颅手术入路显微解剖学研究

目的 为经颅至眶部手术入路提供详细的显微解剖学依据及解剖参数。方法 应用２０例成人头颅湿标本，在放大５￣２０倍显微镜下，对眶内手术入路进行显微解剖分析及测量。结果 内侧入路是经上斜肌与提上睑肌之间的间隙，经此入路可切除眶尖区内侧病变。中央入践是经提上睑肌与上直肌之间的间隙，根据额神经牵向内侧还是牵向外侧分为两种术式；经此入路可行眶内段视神经中段病变的切除。外侧入路是经上直肌与外直肌之间的间隙，根据

Transcranial approach to the orbit : a microanatomical study

OBJECTIVE: To provide detailed knowledge of microanatomy and parameters for transcranial approach to the orbit. METHOD: Three intraorbital approaches were studied by dissecting and measuring 20 adult cadaveric heads under x5 to 25 magnification. RESULTS: The medical approach was directed through the space between the superior oblique and the levator palpebrae superior muscles, which was selected for lesions located in the medial part of the orbital apex. The central approch was directed through the space between the levator palpebrae superior and the superior rectus muscles. There were two variants of the central approach, the choice of which depends on whether the frontal nerve was retracted medially or laterally. The approach was selected for lesions located in the midportion of the intraorbital segment of the optic nerve. The lateral approach was directed through the space between the superior and the lateral rectus muscle. There were two variants of the lateral approach, the choice of which was determined by whether the superior ophthalmic vein is retracted medially or laterally. This approach was selected for lesions located in the superior, inferior or lateral part of the orbital apex as well as the superior orbital fissure. CONCLUSION: This research provides a microanatomical foundation for avioding the important nerves and vessels damage in transcranial to orbital surgery.