Karabuk University, Faculty of Medicine, Department of Neurosurgery, Karabuk, Turkey.
Uludağ University, Faculty of Medicine, Department of Neurosurgery, Bursa, Turkey.
J Craniomaxillofac Surg. 2019 Apr;47(4):561-569. doi: 10.1016/j.jcms.2019.01.027. Epub 2019 Feb 13.
The proximal portion of the optic nerve is quite prone to injury at the entrance of the optic foramen by tumoral or traumatic pathologies. As a result, it is important to show which way and which part we can effectively and safely decompress the pathologies affecting the optic nerves. In this study, we compared the decompression of the proximal segment of the optic canal Likewise, we investigated the anatomy and histopathology of the opticocarotid region from below and above.
A total of 30 adult sellar and parasellar samples were extracted from human cadavers. Anatomical dissection and histological examination were performed from transcranial and transsphenoidal ways. The walls of the proximal optic canal were evaluated with an operating microscope and endoscope. The relationship between the optic canal, the internal carotid artery, and the optic nerve were qualitatively and quantitatively examined.
Similar rates of circular optic canal decompression were achieved by each approach; however, by means of decompression, the transsphenoidal approach was superior for the inferior and medial portions of the optic nerve and transcranial approach was superior for the superior and lateral portions and also more appropriate for optic nerve mobilization.
This is one of the first studies to reveal the ways of the decompression of the proximal optic canal by transcranial and transsphenoidal approaches. According to this study, the medial and inferior proximal portions of the optic nerves are histologically more prone to injury caused by traction or compression. Transcranial or transsphenoidal approach should be preferred according to the location of the pathology and anatomical and histological characteristics of this region.
视神经的近段在视神经孔入口处很容易受到肿瘤或创伤性病变的损伤。因此，重要的是要表明我们可以通过哪种方式和哪个部位有效地和安全地对影响视神经的病变进行减压。在这项研究中，我们比较了视神经管近段的减压效果。同样，我们从颅内向颅外下方和上方研究了视-颈动脉区域的解剖和组织病理学。
从 30 例成人鞍区和鞍旁标本中提取。通过经颅和经蝶窦途径进行解剖和组织学检查。在手术显微镜和内窥镜下评估近端视神经管的壁。定性和定量检查视神经管、颈内动脉和视神经之间的关系。
两种方法的环形视神经管减压率相似；然而，通过减压，经蝶窦入路对于视神经的下内侧部分更为优越，经颅入路对于视神经的上外侧部分更为优越，并且更适合视神经的移动。
这是第一项揭示经颅和经蝶窦入路对近端视神经管减压方式的研究之一。根据这项研究，视神经的近内侧和下侧部分在组织学上更容易受到牵引或压迫引起的损伤。根据病变的位置和该区域的解剖和组织学特征，应优先选择经颅或经蝶窦入路。
