鼻内镜视神经管减压术的相关解剖学研究
发布时间：2018-09-01 12:51
【摘要】：目的: 结合临床手术实际应用需要,通过对视神经管的应用解剖学研究,验证鼻内镜下视神经减压术的可行性和安全性。并且测量此径路手术所需的解剖数据,提供该术式的安全范围,以利于成功开展临床手术,避免并发症的发生,并在尸头标本上培养鼻内镜下的视神经手术技巧。 材料和方法: 1.成人颅骨干标本4例(8侧),经锯切,10%盐酸脱钙后,分别暴露眼眶上壁、蝶、筛窦顶壁及视神经管顶壁,进行解剖观测并用数码相机拍摄,用游标卡尺、圆规和量角器测量各项数据。 2.经10%福尔马林固定的成人尸头6例(12侧),用20%盐酸脱钙后,沿眉弓上1cm水平面锯开,取出脑组织,逐层解剖并测量相关解剖标志的深度、仰角、外偏角等,观察筛窦与蝶窦和视神经管的正常解剖和变异情况。并用数码相机拍摄,用游标卡尺、圆规和量角器测量各项数据。 3对6例(12侧)颅骨湿标本采用经眶下缘与同侧外耳道口上缘的连线(Frankfurt-Virchow Plane FV)为轴位扫描基线进行扫描,采用GE公司的lightspeed16层螺旋CT机,并对图像进行分析。 结果: 1.成人颅骨干标本的各项结果(用(?)±SD表示):(1)视神经颅口的横径和纵径的数值9.45±0.76mm和5.20±0.65mm,(2)视神经眶口的横径和纵径长度的数值5.28±0.62mm和6.91±0.85mm,(3)视神经上壁长度和厚度的数值9.69±1.64mm和2.09±0.47mm,(4)视神经外侧壁长度和厚度的数值6.11±1.73mm和1.73±0.25mm,(5)视神经内侧壁长度和厚度的数值9.81±1.67mm和2.23±0.39mm,(6)视神经下壁长度的数值3.68±0.66mm,(7)前鼻棘到视神经管眶口内侧壁中点的距离65.60±1.38mm,(8)前鼻棘到视神经管颅口内侧的距离66.89±1.83mm,(9)中鼻甲附着处前端到视神经管眶口内侧壁中点的距离
[Abstract]:Objective: to verify the feasibility and safety of optic nerve decompression under nasal endoscope by studying the applied anatomy of optic canal. The anatomic data needed for the operation were measured to provide a safe range for the successful clinical operation and to avoid complications. The technique of optic nerve surgery under nasal endoscope was cultured on the cadaveric head specimen. Materials and methods: 1. After 10% hydrochloric acid decalcification, the supraorbital wall, sphenoid wall, ethmoid sinus parietal wall and parietal wall of optic canal were exposed in 4 adult skull specimens (8 sides). Gauges and gauges for measuring data. 2. Six adult cadavers (12 sides) fixed with 10% formalin were decalcified with 20% hydrochloric acid. The brain tissue was removed by sawing along the horizontal plane of 1cm on the brow arch, and the depth, elevation angle and lateral angle of the related anatomical markers were measured and dissected layer by layer. To observe the normal anatomy and variation of ethmoid sinus, sphenoid sinus and optic canal. And shoot with a digital camera, with a Vernier caliper, The data were measured by compasses and proturers. 3. 6 cases (12 sides) of wet skulls were scanned by the line between the inferior orbital margin and the superior edge of the ipsilateral external auditory meatus (Frankfurt-Virchow Plane FV) as the axial scanning baseline). The helical CT machine of lightspeed16 layer of GE company is adopted, and the image is analyzed. Results: 1. Results of adult cranial trunk specimens (?) 卤SD for): (1) the transverse and longitudinal diameters of the cranial orifice of the optic nerve were 9.45 卤0.76mm and 5.20 卤0.65mm, (2) the transverse and longitudinal diameters of the orbital orifice of the optic nerve 5.28 卤0.62mm and 6.91 卤0.85mm, (3) the length and thickness of the superior wall of the optic nerve 9.69 卤1.64mm and 2.09 卤0.47mm, (4) The length and thickness of the lateral wall of the optic nerve were 6.11 卤1.73mm and 1.73 卤0.25mm, (5) the length and thickness of the medial wall of the optic nerve 9.81 卤1.67mm and 2.23 卤0.39mm, (6) the length of the inferior wall of the optic nerve 3.68 卤0.66mm, (7) the distance between the anterior nasal spine and the middle point of the medial orbital wall of the optic canal, 65.60 卤1.38mm, and (8) the anterior nasal spine to the optic nerve. (9) the distance from the anterior end of the middle turbinate to the midpoint of the medial orbital wall of the optic canal.
【学位授予单位】：天津医科大学
【学位级别】：硕士
【学位授予年份】：2006
【分类号】：R779.6;R322
本文编号：2217253
[Abstract]:Objective: to verify the feasibility and safety of optic nerve decompression under nasal endoscope by studying the applied anatomy of optic canal. The anatomic data needed for the operation were measured to provide a safe range for the successful clinical operation and to avoid complications. The technique of optic nerve surgery under nasal endoscope was cultured on the cadaveric head specimen. Materials and methods: 1. After 10% hydrochloric acid decalcification, the supraorbital wall, sphenoid wall, ethmoid sinus parietal wall and parietal wall of optic canal were exposed in 4 adult skull specimens (8 sides). Gauges and gauges for measuring data. 2. Six adult cadavers (12 sides) fixed with 10% formalin were decalcified with 20% hydrochloric acid. The brain tissue was removed by sawing along the horizontal plane of 1cm on the brow arch, and the depth, elevation angle and lateral angle of the related anatomical markers were measured and dissected layer by layer. To observe the normal anatomy and variation of ethmoid sinus, sphenoid sinus and optic canal. And shoot with a digital camera, with a Vernier caliper, The data were measured by compasses and proturers. 3. 6 cases (12 sides) of wet skulls were scanned by the line between the inferior orbital margin and the superior edge of the ipsilateral external auditory meatus (Frankfurt-Virchow Plane FV) as the axial scanning baseline). The helical CT machine of lightspeed16 layer of GE company is adopted, and the image is analyzed. Results: 1. Results of adult cranial trunk specimens (?) 卤SD for): (1) the transverse and longitudinal diameters of the cranial orifice of the optic nerve were 9.45 卤0.76mm and 5.20 卤0.65mm, (2) the transverse and longitudinal diameters of the orbital orifice of the optic nerve 5.28 卤0.62mm and 6.91 卤0.85mm, (3) the length and thickness of the superior wall of the optic nerve 9.69 卤1.64mm and 2.09 卤0.47mm, (4) The length and thickness of the lateral wall of the optic nerve were 6.11 卤1.73mm and 1.73 卤0.25mm, (5) the length and thickness of the medial wall of the optic nerve 9.81 卤1.67mm and 2.23 卤0.39mm, (6) the length of the inferior wall of the optic nerve 3.68 卤0.66mm, (7) the distance between the anterior nasal spine and the middle point of the medial orbital wall of the optic canal, 65.60 卤1.38mm, and (8) the anterior nasal spine to the optic nerve. (9) the distance from the anterior end of the middle turbinate to the midpoint of the medial orbital wall of the optic canal.
【学位授予单位】：天津医科大学
【学位级别】：硕士
【学位授予年份】：2006
【分类号】：R779.6;R322
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