Lieber Stefan, Fernandez-Miranda Juan C
Department of Neurosurgery, Stanford University Medical Center, Palo Alto, California, United States.
J Neurol Surg B Skull Base. 2020 Aug;81(4):319-332. doi: 10.1055/s-0040-1715096. Epub 2020 Sep 17.
The orbit is a paired, transversely oval, and cone-shaped osseous cavity bounded and formed by the anterior and middle cranial base as well as the viscerocranium. Its main contents are the anterior part of the visual system, globe and optic nerve, and the associated neural, vascular, muscular, glandular, and ligamentous structures required for oculomotion, lacrimation, accommodation, and sensation. A complex stream of afferent and efferent information passes through the orbit, which necessitates a direct communication with the anterior and middle cranial fossae, the pterygopalatine and infratemporal fossae, as well as the aerated adjacent frontal, sphenoidal, and maxillary sinuses and the nasal cavity. This article provides a detailed illustration and description of the microsurgical anatomy of the orbit, with a focus on the intrinsically complex spatial relationships around the annular tendon and the superior orbital fissure, the transition from cavernous sinus to the orbital apex. Sparse reference will be made to surgical approaches, their indications or limitations, since they are addressed elsewhere in this special issue. Instead, an attempt has been made to highlight anatomical structures and elucidate concepts most relevant to safe and effective transcranial, transfacial, transorbital, or transnasal surgery of orbital, periorbital, and skull base pathologies.
眼眶是一对呈横向椭圆形的锥形骨性腔隙，由前颅底、中颅底以及面颅骨界定并构成。其主要内容物包括视觉系统的前部、眼球和视神经，以及眼球运动、泪液分泌、调节和感觉所需的相关神经、血管、肌肉、腺体和韧带结构。复杂的传入和传出信息流通过眼眶，这就需要与前颅窝、中颅窝、翼腭窝和颞下窝，以及相邻的含气额窦、蝶窦和上颌窦及鼻腔直接相通。本文详细阐述了眼眶的显微外科解剖结构，重点关注围绕环形肌腱和眶上裂的内在复杂空间关系，即从海绵窦到眶尖的过渡。由于本专题其他地方已涉及手术入路、其适应证或局限性，因此本文仅作简要提及。相反，本文试图突出与眼眶、眶周及颅底病变的安全有效经颅、经面、经眶或经鼻手术最相关的解剖结构并阐明相关概念。
