Ruskell Gordon L
Department of Optometry and Visual Science, City University, Applied Vision Research Centre, Dame Alice Owen Building 311-321 Goswell Road, London EC1V 7DD, UK.
Exp Eye Res. 2004 Mar;78(3):329-35. doi: 10.1016/j.exer.2003.06.001.
To trace the path taken by the putative postganglionic secretomotor fibres to the lacrimal gland the contents of the orbital and pterygopalatine fossa were removed whole, cut coronally into slabs and embedded in resin. Thin sections were cut at varying intervals to reconstruct the pathway taken. One group of rami orbitales issuing from the pterygopalatine ganglion passed dorsally adjacent to the lateral wall of the orbit, joined the retro-orbital plexus at the apex, and 5-10 rami lacrimales advanced from the plexus to enter the gland. An accessory ophthalmic artery, a branch of the middle meningeal artery, entered the orbit through the superior fissure orbital joining the ophthalmic or lacrimal artery. Perivascular nerves of the artery continued to the gland as supplementary rami lacrimales and in some orbits others served the vasculature of the eye and orbit. The nerves are presumably derived from the middle meningeal supply and may include otic parasympathetic fibres. The route taken by parasympathetic nerves serving the human lacrimal gland is demonstrated here for the first time and apart from the perivascular meningeal artery source, it is similar to that described in monkeys. The traditional assumption that secretomotor nerves pass to the gland via the zygomatic and lacrimal nerves is therefore unlikely and clinical measures to reduce lacrimation based on that assumption and involving severance of ophthalmic branches is not indicated.
为追踪假定的节后分泌运动纤维至泪腺所走的路径，将眶部和翼腭窝的内容物完整取出，冠状切成薄片并包埋于树脂中。以不同间隔切取薄片以重建所走的路径。一组发自翼腭神经节的眶支沿眶侧壁背侧走行，在眶尖处汇入眶后丛，5 - 10支泪腺支从该丛发出进入泪腺。脑膜中动脉的一支副眼动脉经眶上裂进入眶内，与眼动脉或泪腺动脉汇合。该动脉的血管周围神经作为补充泪腺支继续延伸至泪腺，在一些眼眶中，其他神经则为眼和眼眶的血管系统提供服务。这些神经大概来自脑膜中动脉的供血，可能包括耳副交感神经纤维。此处首次展示了支配人类泪腺的副交感神经所走的路径，除了血管周围脑膜动脉来源外，它与在猴子中描述的路径相似。因此，传统观点认为分泌运动神经通过颧神经和泪腺神经到达泪腺不太可能成立，基于该假设且涉及切断眼支来减少流泪的临床措施并无依据。
