Orbital dekompressyon cerrahisinde Fissura Orbitalis Inferior'un anatomik landmarkları
Yükleniyor...
Dosyalar
Tarih
2008
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Ege Üniversitesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Fissura orbitalis inferior (FOI), beyin dekompresyon cerrahisinde önemli bir bölge olmasına
rağmen anatomik detayına ilişkin bilgisi oldukça azdır. Dekompresyon cerrahisi beyin
cerrahları tarafından sıkça uygulanılan kafatabanı ve damarsal girişimi içeren bir yönü ile
anatomik içeriği ve bağlantılarının bilinmesi oldukça değerlidir. FOI’nin sefalometrik
değerlendirmesi ve anatomik yapısının incelenmesi 232 insan yetişkin orbita’sında yapıldı.
Standart cerrahi aletlerle 36 taraf olmak üzere 18 insan kadavrasında pterional yaklaşım
uygulandı.
FOI çevresi 50.6 ± 13.5 mm; elan 61.3 ± 39.1 mm2; en uzun kenar 18.2 ± 4.9 mm; en dar
mesafesi 1.9 ± 1.3 mm; en geniş kenar 5.7 ± 2.6 mm; delik çapı 2.9 ± 1.1 mm, iç açı 38.4 ±
24.7 derece; dış açı 138.9 ± 32.7 derece olarak saptandı. En sık Tip I olarak tanımlanan en
geniş kısmı medialde dar açıklığı üst dışa doğru uzanan bir şekil olarak gözlendi (%42.2).
Orbita bölgesi ve FOI cerrahi anatomisi önemli anatomik yapıların geçit bölgesi olduğu için
oldukça karışık bir bölgedir. Graves hastalığının göz fırlaklığında yapılacak orbital
dekompresyon cerrahisi sonrasında diplopia görülmektedir. Dekompresyon cerrahisinde en
düşük komplikasyon lateral duvarın kullanılması sonucunda olur. Bu çalışmada elde edilen
bulgular orbita lateral duvarınından başlayacak dekompresyonun aşağıdaya ve de
superolaterale doğru devamı yönünde olmalıdır.
The inferior orbital fissure (IOF) is an important area in the neurosurgical decompression surgery, but the anatomical features of the IOF and the procedures necessary to fully expose it and its contents have not been detailed. Although the decompression surgery is commonly used during skull base or vascular surgery by neurosurgeons who may already be familiar with its nuances and anatomical relationships to the IOF, this knowledge may also be useful to the wider neurosurgical community. The cephalometric analysis of the IOF and related anatomic structures were studied in 232 orbits of adult human skulls. Using standard microsurgical equipment and instruments, the authors performed 36 superolateral orbital approaches in 18 embalmed cadaver heads in which the vascular systems had been injected with colored material. Some measurements were measured such as circle 50.6 ± 13.5 mm; square 61.3 ± 39.1 mm2; longest 18.2 ± 4.9 mm; shortest 1.9 ± 1.3 mm; heightest 5.7 ± 2.6 mm; diameter of infraorbital canal 2.9 ± 1.1 mm; inner angle 38.4 ± 24.7°; outer angle 138.9 ± 32.7°. The most common types of IOF was Type I 42.2%. Surgery involving the orbital region and the IOF is complex because of the important anatomical structures traversing the area. The contribution of the lateral wall resection to exophalmos reduction also has been assessed in former studies, as has its potential influence on the onset of consecutive diplopia. The findings of our study suggest that removal of lateral wall should be started inferiorly, just lateral to the IOF and then extented superolaterally.
The inferior orbital fissure (IOF) is an important area in the neurosurgical decompression surgery, but the anatomical features of the IOF and the procedures necessary to fully expose it and its contents have not been detailed. Although the decompression surgery is commonly used during skull base or vascular surgery by neurosurgeons who may already be familiar with its nuances and anatomical relationships to the IOF, this knowledge may also be useful to the wider neurosurgical community. The cephalometric analysis of the IOF and related anatomic structures were studied in 232 orbits of adult human skulls. Using standard microsurgical equipment and instruments, the authors performed 36 superolateral orbital approaches in 18 embalmed cadaver heads in which the vascular systems had been injected with colored material. Some measurements were measured such as circle 50.6 ± 13.5 mm; square 61.3 ± 39.1 mm2; longest 18.2 ± 4.9 mm; shortest 1.9 ± 1.3 mm; heightest 5.7 ± 2.6 mm; diameter of infraorbital canal 2.9 ± 1.1 mm; inner angle 38.4 ± 24.7°; outer angle 138.9 ± 32.7°. The most common types of IOF was Type I 42.2%. Surgery involving the orbital region and the IOF is complex because of the important anatomical structures traversing the area. The contribution of the lateral wall resection to exophalmos reduction also has been assessed in former studies, as has its potential influence on the onset of consecutive diplopia. The findings of our study suggest that removal of lateral wall should be started inferiorly, just lateral to the IOF and then extented superolaterally.
Açıklama
Anahtar Kelimeler
Cerrahi Anatomi, Fissura Orbitalis İnferior, Orbita, Dekompresyon Cerrahisi, Surgical Anatomy, Inferior Orbital Fissure, Orbit, Decompression Surgery
