Benedicic Mitja, Debevc David, Dolenc Vinko V, Bosnjak Roman
Department of Neurosurgery, University Medical Center, Ljubljana, Slovenia.
Croat Med J. 2006 Apr;47(2):292-7.
To determine ocular, sudomotor, and vasomotor components of Horner's syndrome resulting from complete unilateral intraoperative damage to the parasellar sympathetic fibers during cavernous sinus surgery.
Complete damage to the parasellar sympathetic fibers was found in four patients operated for central skull base lesions. Pupilometry, eyelid fissure measurement, Hertel's exophthalmometry, starch iodine sweat test, and laser-Doppler perfusion assessment of bilaterally symmetrical forehead and cheek areas were performed.
Pupil diameter was smaller and the eyelid fissure was >2 mm narrower on the affected side in all four patients. Exophthalmometry after the operation never revealed >1 mm difference. Anhydrosis was localized to the medial forehead in three and to the entire forehead in one patient. Average perfusion did not significantly differ between the affected and opposite side of the forehead or cheek.
The parasellar sympathetic fibers exclusively innervate the orbit and variably innervate the forehead sweat glands. No conclusion regarding their contribution to the facial vasomotor control could be established.
确定海绵窦手术中单侧鞍旁交感神经纤维完全术中损伤所致霍纳综合征的眼部、汗腺运动和血管运动成分。
在4例因中央颅底病变接受手术的患者中发现鞍旁交感神经纤维完全损伤。进行了瞳孔测量、睑裂测量、赫特尔眼球突出度测量、淀粉碘汗试验以及双侧对称的前额和脸颊区域的激光多普勒灌注评估。
所有4例患者患侧瞳孔直径较小，睑裂窄>2 mm。术后眼球突出度测量未显示>1 mm的差异。3例患者的无汗局限于前额内侧，1例患者的无汗累及整个前额。前额或脸颊患侧与对侧的平均灌注无显著差异。
鞍旁交感神经纤维专门支配眼眶，并可变地支配前额汗腺。关于它们对面部血管运动控制的作用尚无定论。
