内镜经上颌窦入路眶下/上颌神经解剖

摘要

Objective To explore the localization and guidance value of infraorbital/maxillary nerve in endoscopic transmaxillary approach, and to provide anatomical data for clinical operation. Methods The eight adult cadaver heads were dissected by means of the endoscopic transmaxillary approach to expose the infraorbital/maxillary nerve, and relevant data were collected. Results In 8 cases, 16 maxillary nerves arose from the trigeminal ganglion of the trigeminal nerve and emerged from the foramen rotundum, transited to the infraorbital nerve at the infraorbital fissure, then traveled in the infraorbital canal and out of the infraorbital foramen. The infraorbital/maxillary nerve could be divided into four segments according to the foramen rotundum, infraorbital groove and infraorbital foramen: the terminal segment, the infraorbital nerve and its terminal branches to the face, distal to the infraorbital foramen; the orbitomaxillary segment and the orbitomaxillary segment of the infraorbital nerve within the infraorbital canal from the infraorbital foramen along the infraorbital groove (length 11.7 ±2.5 mm ), which was readily identified in the roof of the maxillary sinus in all specimens. The pterygopalatine segment, the pterygopalatine segment within the pterygopalatine fossa, which started at the infraorbital groove to the foramen rotundum (length 13.4±2.1 mm); The intracranial segment, the intracranial segment from the foramen rotundum to the trigeminal ganglion(length 15.2±3.9 mm). Conclusion The infraorbital nerve can serve as a anatomical landmark for endoscopic transmaxillary approach to get access to infratemporal fossa, pterygopalatine fossa, trigeminal ganglion and lateral wall of the cavernous sinus.%目的 探讨眶下/上颌神经在内镜经上颌窦入路中的定位引导作用,为临床手术提供解剖学资料.方法 对8例成人头颅标本通过模拟内镜下经上颌窦入路对眶下/上颌神经进行解剖,并测量和采集相关数据图片.结果 8例标本16侧上颌神经从三叉神经半月节分出后,均从圆孔出颅,在眶下裂处移行为眶下神经,行走于眶下管内从眶下孔出眼眶.利用圆孔、眶下裂、眶下孔,眶下/下颌神经可分成四段:终末段,眶下神经出眶下孔之后;眼眶-上颌窦段,位于眶下管内,眶下神经进眶下裂至出眶下孔之前,长度为(11.7±2.5)mm,该段在上颌窦内即可清晰辨认;翼腭段,上颌神经出圆孔至入眶下裂之前,长度为(13.4±2.1)mm;颅内段,下颌神经从三叉神经节分出后至出圆孔之前,长度为(15.2±3.9)mm.结论 在内镜经上颌窦入路中,利用眶下神经/上颌神经的走形可引导进入颞下窝、翼腭窝、三叉神经节及海绵窦外侧壁.