Parent A D, Das S K, Mallette R A, Haines D E
Department of Neurosurgery, University of Mississippi Medical Center, Jackson 39216-4505.
Pediatr Neurosurg. 1993 Mar-Apr;19(2):73-7. doi: 10.1159/000120703.
Craniofacial approaches to the anterior skull base involve manipulation or removal of the supraorbital and frontozygomatic orbital margins. Necessarily, structures within the orbit are detached from the orbital margins. The lateral canthal tendon is attached to the inner aspect of the frontozygomatic process on the orbital osseous tubercle and is essential to the structural fixation of the lateral canthus as well as a check on the mobility of the lateral canthal angle of the eye itself. Our anatomic studies on the lateral canthal tendon as well as specific neurosurgical considerations in its mobilization are reviewed. The detachment of the lateral canthal tendon may result in blunting of the lateral canthal angle, a distraction of the eyelid away from the globe, or an asymmetric repositioning of the canthus as compared with the contralateral angle. It would appear that if the periosteum of the orbit is carefully dissected from the orbital rim and reapproximated following the procedure, the lateral canthal tendon insertion and function will not be disturbed unless the bony orbit margins are altered. In these instances, further ocular plastic surgery may be required.
颅面入路至前颅底涉及眶上缘和额颧眶缘的操作或切除。必然地，眶内结构会从眶缘分离。外眦韧带附着于眶骨结节处额颧突的内侧面，对于外眦的结构固定以及限制眼外眦角的活动至关重要。本文回顾了我们对外眦韧带的解剖学研究以及其在游离过程中的特定神经外科注意事项。外眦韧带的分离可能导致外眦角变钝、眼睑与眼球分离，或与对侧眦角相比眦角不对称复位。似乎如果在手术过程中小心地从眶缘分离眶骨膜并重新对合，除非眶骨边缘改变，外眦韧带的附着和功能不会受到干扰。在这些情况下，可能需要进一步的眼部整形手术。
