Natori Y, Rhoton A L
Department of Neurological Surgery, University of Florida, Gainesville, USA.
Neurosurgery. 1995 Apr;36(4):762-75. doi: 10.1227/00006123-199504000-00018.
The microsurgical anatomy of the superior orbital fissure was examined in cadaver specimens. The cavernous sinus fills the posterior margin and the orbital contents fill the anterior margin of the fissure. All of the nerves coursing in the walls of the cavernous sinus pass through the superior orbital fissure to reach the orbit. The fissure has a narrow lateral part and a larger medial part. The annular tendon from which the rectus muscles arise is situated in front of the upper half of the medial part of the fissure and is attached to the lateral margin near the junction of the lateral and medial parts. The fissure is divided into three sectors: lateral, central, and inferior. The lateral sector, which corresponds to the narrow lateral part, transmits the trochlear, frontal, and lacrimal nerves and the superior ophthalmic vein, all of which course outside the annular tendon. The central sector, which is situated behind and is aligned with the lateral part of the annular tendon, transmits the superior and inferior divisions of the oculomotor nerve, the abducens and nasociliary nerves, and the sensory and sympathetic roots of the ciliary ganglion, all of which pass through the annular tendon. The inferior sector, which is located below the annular tendon and origin of the inferior rectus muscle, is filled with a posterior extension of the orbital fat and transmits the inferior ophthalmic vein. The relationship and course of the nerves in each sector and the incisions that may be used to open and expose the contents of the fissure are reviewed.
在尸体标本上研究了眶上裂的显微外科解剖结构。海绵窦占据裂隙的后缘，眶内容物占据裂隙的前缘。所有走行于海绵窦壁内的神经均通过眶上裂到达眼眶。该裂隙有一个狭窄的外侧部分和一个较大的内侧部分。直肌起始的环行腱位于裂隙内侧部分上半的前方，并附着于外侧和内侧部分交界处附近的外侧缘。裂隙分为三个部分：外侧部、中部和下部。外侧部对应狭窄的外侧部分，通过滑车神经、额神经、泪腺神经和眼上静脉，它们均走行于环行腱之外。中部位于环行腱外侧部的后方并与之对齐，通过动眼神经上、下支、展神经、鼻睫神经以及睫状神经节的感觉根和交感根，它们均穿过环行腱。下部位于环行腱和下直肌起点的下方，充满眶脂肪的后延部分，并通过眼下静脉。回顾了每个部分神经的关系和走行以及可用于打开和暴露裂隙内容物的切口。
