發(fā)布時(shí)間：2018-09-01 12:51

【摘要】：目的: 結(jié)合臨床手術(shù)實(shí)際應(yīng)用需要,通過對視神經(jīng)管的應(yīng)用解剖學(xué)研究,驗(yàn)證鼻內(nèi)鏡下視神經(jīng)減壓術(shù)的可行性和安全性。并且測量此徑路手術(shù)所需的解剖數(shù)據(jù),提供該術(shù)式的安全范圍,以利于成功開展臨床手術(shù),避免并發(fā)癥的發(fā)生,并在尸頭標(biāo)本上培養(yǎng)鼻內(nèi)鏡下的視神經(jīng)手術(shù)技巧。 材料和方法: 1.成人顱骨干標(biāo)本4例(8側(cè)),經(jīng)鋸切,10%鹽酸脫鈣后,分別暴露眼眶上壁、蝶、篩竇頂壁及視神經(jīng)管頂壁,進(jìn)行解剖觀測并用數(shù)碼相機(jī)拍攝,用游標(biāo)卡尺、圓規(guī)和量角器測量各項(xiàng)數(shù)據(jù)。 2.經(jīng)10%福爾馬林固定的成人尸頭6例(12側(cè)),用20%鹽酸脫鈣后,沿眉弓上1cm水平面鋸開,取出腦組織,逐層解剖并測量相關(guān)解剖標(biāo)志的深度、仰角、外偏角等,觀察篩竇與蝶竇和視神經(jīng)管的正常解剖和變異情況。并用數(shù)碼相機(jī)拍攝,用游標(biāo)卡尺、圓規(guī)和量角器測量各項(xiàng)數(shù)據(jù)。 3對6例(12側(cè))顱骨濕標(biāo)本采用經(jīng)眶下緣與同側(cè)外耳道口上緣的連線(Frankfurt-Virchow Plane FV)為軸位掃描基線進(jìn)行掃描,采用GE公司的lightspeed16層螺旋CT機(jī),并對圖像進(jìn)行分析。 結(jié)果: 1.成人顱骨干標(biāo)本的各項(xiàng)結(jié)果(用(?)±SD表示):(1)視神經(jīng)顱口的橫徑和縱徑的數(shù)值9.45±0.76mm和5.20±0.65mm,(2)視神經(jīng)眶口的橫徑和縱徑長度的數(shù)值5.28±0.62mm和6.91±0.85mm,(3)視神經(jīng)上壁長度和厚度的數(shù)值9.69±1.64mm和2.09±0.47mm,(4)視神經(jīng)外側(cè)壁長度和厚度的數(shù)值6.11±1.73mm和1.73±0.25mm,(5)視神經(jīng)內(nèi)側(cè)壁長度和厚度的數(shù)值9.81±1.67mm和2.23±0.39mm,(6)視神經(jīng)下壁長度的數(shù)值3.68±0.66mm,(7)前鼻棘到視神經(jīng)管眶口內(nèi)側(cè)壁中點(diǎn)的距離65.60±1.38mm,(8)前鼻棘到視神經(jīng)管顱口內(nèi)側(cè)的距離66.89±1.83mm,(9)中鼻甲附著處前端到視神經(jīng)管眶口內(nèi)側(cè)壁中點(diǎn)的距離
[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 (?) 鹵SD for): (1) the transverse and longitudinal diameters of the cranial orifice of the optic nerve were 9.45 鹵0.76mm and 5.20 鹵0.65mm, (2) the transverse and longitudinal diameters of the orbital orifice of the optic nerve 5.28 鹵0.62mm and 6.91 鹵0.85mm, (3) the length and thickness of the superior wall of the optic nerve 9.69 鹵1.64mm and 2.09 鹵0.47mm, (4) The length and thickness of the lateral wall of the optic nerve were 6.11 鹵1.73mm and 1.73 鹵0.25mm, (5) the length and thickness of the medial wall of the optic nerve 9.81 鹵1.67mm and 2.23 鹵0.39mm, (6) the length of the inferior wall of the optic nerve 3.68 鹵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 鹵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.
【學(xué)位授予單位】：天津醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2006
【分類號(hào)】：R779.6;R322

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