Hester Kathylin M, Rahimi Omid B, Fry Constance L, Nation Haley L
Department of Cell Systems and Anatomy, UT Health San Antonio, San Antonio, TX, USA.
Department of Ophthalmology, UT Health San Antonio, San Antonio, TX, USA.
Anat Cell Biol. 2021 Sep 30;54(3):297-303. doi: 10.5115/acb.21.013.
The purpose of this study is to investigate the applicability of the current surgical guideline, known as '24-12-6' surgical guideline, in the Hispanic and European populations. This guideline is used during numerous orbital surgeries and states that the distance between the anterior lacrimal crest (ALC) to the anterior ethmoidal foramen (AEF) (24 mm), the AEF to the posterior ethmoidal foramen (PEF) (12 mm), and the PEF to the optic canal (OC) (6 mm) follows a Rule of Halves. Previous studies suggest this surgical guideline is not applicable for all ethnicities; however, to our knowledge, no data has been published regarding the accuracy of this guideline pertaining to the Hispanic population. An experimental study was performed on 79 orbits (52 cadavers) donated to the Human Anatomy Program at UT Health San Antonio. The ALC, AEF, posterior ethmoidal foramen, and OC were identified; the orbit was enucleated and all remaining soft tissue removed. The distance between each landmark was recorded using a digital caliper. For all cadavers studied, the distances between the ALC, AEF, posterior ethmoidal foramen, and OC were 24.76 mm, 13.89 mm, and 7.61 mm, respectively. Thus, the '24-12-6' surgical guideline was not applicable to the sample studied. Based on ethnicity data, these relationships were also not true for the European or the Hispanic populations. Therefore, significant anatomical variations exist in the current surgical guideline. Clinicians may need to adjust their methodology during surgical procedures in order to optimize patient care.
本研究的目的是调查当前被称为“24 - 12 - 6”手术指南在西班牙裔和欧洲人群中的适用性。该指南在众多眼眶手术中使用，规定从泪前嵴（ALC）到筛前孔（AEF）的距离为24毫米，从AEF到筛后孔（PEF）的距离为12毫米，从PEF到视神经管（OC）的距离为6毫米，遵循减半规则。先前的研究表明，该手术指南并非适用于所有种族；然而，据我们所知，尚无关于该指南在西班牙裔人群中准确性的数据发表。对捐赠给德克萨斯大学圣安东尼奥健康科学中心人体解剖项目的79个眼眶（52具尸体）进行了一项实验研究。确定了ALC、AEF、筛后孔和OC；摘除眼眶并去除所有剩余软组织。使用数字卡尺记录每个标志点之间的距离。对于所有研究的尸体，ALC、AEF、筛后孔和OC之间的距离分别为24.76毫米、13.89毫米和7.61毫米。因此，“24 - 12 - 6”手术指南不适用于所研究的样本。根据种族数据，这些关系在欧洲或西班牙裔人群中也不成立。因此，当前的手术指南存在显著的解剖学差异。临床医生在手术过程中可能需要调整其方法，以优化患者护理。
