眼眶是容纳视器及视器血管、神经的锥形腔隙,其周围毗邻关系非常复杂:4对鼻旁窦位于眶周,眶尖的眶上裂及视神经管向后通颅中窝,下壁的眶下裂向后与颞下窝、翼腭窝相通。因此,眶内与眶周毗邻结构的疾病可相互影响。在眶区手术中,医生掌握详尽的解剖学知识将可避免手术对病人视力及眼球运动功能可能造成的副损伤。本文综述了眶的骨学特征、眼动脉的分支及临床意义、视神经眶内段的应用解剖、眶内手术入路及选择依据。 1 眶的骨学特征 成人眶容积25～28ml,眶口宽40mm,高35mm,眶的最宽部并不在眶缘而在眶缘后约10mm处。眶深(眶轴长)40～50mm,当做球后麻醉时,针刺深度不可超过40mm,以免刺入颅腔。内眶距(两眶内侧缘间距离)男性平均20.8mm,女性20.3mm;外眶距两眶外侧缘间距离)男性平均96.0mm,女性93.1mm。 1.1 眶的构成 眶呈四面锥体形深腔,分一底、一尖、四壁。(1)底:即眶口。略呈四边形,向前下外倾斜。眶缘较厚,而且各缘并非处于同一平面上:眶外侧缘较内侧缘后退约1.5cm,眶下缘也较眶上缘稍居后方。在眶上缘中、内1/3交界处,距正中线约2.5cm处有眶上切迹或眶上孔,其中两侧均呈切迹者 The orbital is to accommodate the visual and vascular vessels, nerves conical lacuna, the surrounding adjacent relationship is very complicated: 4 on the paranasal sinus orbital, orbital apex of the superior orbital fissure and optic canal back through the skull midfielder, under The infraorbital fissure posteriorly communicates with the infratemporal fossa and the pterygopalatine fossa. Therefore, the orbital and periorbital adjacent structures can affect each other’s diseases. In orbital surgery, doctors have a thorough knowledge of anatomy to avoid possible side effects of surgery on patient vision and eye movement. This article reviews orbital osteology, branches and clinical significance of ophthalmic artery, application anatomy of orbital segment of optic nerve, orbital surgery approach and selection basis. 1 Orbital osteology Adult orbital volume of 25 ~ 28ml, orbital width 40mm, high 35mm, the widest part of the orbit is not in the orbital margin and about 10mm behind the orbital margin. Orbital depth (orbital axis length) 40 ~ 50mm, as the ball after anesthesia, acupuncture depth can not exceed 40mm, so as not to pierce the cranial cavity. The internal orbital distance (the distance between the two orbital lateral margins) was 20.8 mm in males and 20.3 mm in females. The distance between external orbital foramen and lateral orbital margin was 96.0 mm in males and 93.1 mm in females. 1.1 The orbital structure Orbital was surrounded by deep pyramidal four-shaped cavity, at the end, a sharp, four walls. (1) at the end: that orbital orifice. Slightly quadrilateral, tilted forward and outward. The orbital rim thicker, and the edge is not in the same plane: the lateral orbital rim than the medial edge receded about 1.5cm, lower orbital margin of the orbital margin slightly behind the rear. In the supraorbital margin, the inner 1/3 junction, about 2.5cm from the midline there are supraorbital notch or supraorbital foramen, both sides were cut notch who