Комплексный обзор анатомии зрительного нерва и нейрохирургических доступов на основе кадаверных срезов

Зрение – это сложный орган чувств, широко представленный в коре головного мозга и включающий в себя множество трактов, которые могут быть затронуты заболеваниями, поддающимися хирургическому лечению. В нейрохирургии лечение основных поражений, влияющих на зрительный нерв, таких как опухоли, внутричерепная гипертензия, травмы и аневризмы, можно рассматривать с точки зрения сегмента, на котором ведется оперативное вмешательство, и окружающих структур, подвергаемых хирургическим манипуляциям. Для выполнения хирургических манипуляций на зрительных путях требуется детальное понимание функциональной нейроанатомии. Цель данной работы – продемонстрировать функциональную и микрохирургическую анатомию зрительного нерва с помощью иллюстраций и кадаверных срезов, что необходимо для выбора оптимального хирургического доступа и исключения ятрогенных повреждений. Для достижения поставленной цели был подготовлен обзор литературы с использованием базы данных PubMed. Кроме того, была выполнена кадаверная диссекция препаратов голов взрослых людей, фиксированных формальдегидом с инъекцией сосудов цветным силиконом.

1. Hayreh S.S. Structure of the optic nerve. Ischemic optic neuropathies. Berlin, Heidelberg: Springer Berlin Heidelberg, 2011. P. 7–34. https://doi.org/10.1007/978-3-642-11852-4. ISBN 978-3-642-11849-4. e-ISBN 978-3-642-11852-4

2. López-Elizalde R., Campero A., Sánchez-Delgadillo T., et al. Anatomy of the olfactory nerve: a comprehensive review with cadaveric dissection. Clin Anat. 2018; 31(1): 109–117. https://doi.org/10.1002/ca.23003. PMID: 29088516.

3. Miller N.R. Primary tumours of the optic nerve and its sheath. Eye (Lond). 2004; 18(11): 1026-1037. https://doi.org/10.1038/sj.eye.6701592. PMID: 15534587.

4. Dissabandara L.O., Nirthanan S.N., Khoo T.K., Tedman R. Role of cadaveric dissections in modern medical curricula: a study on student perceptions. Anat Cell Biol. 2015; 48(3): 205–212. https://doi.org/10.5115/acb.2015.48.3.205. PMID: 26417481.

5. Sterling P. Some principles of retinal design: the proctor lecture. Invest Ophthalmol Vis Sci. 2013; 54(3): 2267–2275. https://doi.org/10.1167/iovs.12-10788. PMID: 23539161.

6. Wu W., Rigolo L., O’Donnell L.J., et al. Visual pathway study using in vivo diffusion tensor imaging tractography to complement classic anatomy. Neurosurgery. 2012; 70(1 Suppl Operative): 145–156; discussion 156. https://doi.org/10.1227/NEU.0b013e31822efcae. PMID: 21808220.

7. Hoon M., Okawa H., Della Santina L., Wong R.O. Functional architecture of the retina: development and disease. Prog Retin Eye Res. 2014; 42: 44–84. https://doi.org/10.1016/j.preteyeres.2014.06.003. PMID: 24984227.

8. Tao C., Zhang X. Development of astrocytes in the vertebrate eye. Dev Dyn. 2014; 243(12): 1501–1510. https://doi.org/10.1002/dvdy.24190. PMID: 25236977.

9. Rieke F. Mechanisms of single-photon detection in rod photoreceptors. Methods Enzymol. 2000; 316: 186–202. https://doi.org/10.1016/s0076-6879(00)16724-2. PMID: 10800676.

10. Wells-Gray E.M., Choi S.S., Bries A., Doble N. Variation in rod and cone density from the fovea to the mid-periphery in healthy human retinas using adaptive optics scanning laser ophthalmoscopy. Eye (Lond). 2016; 30(8): 1135–1143. https://doi.org/10.1038/eye.2016.107. PMID: 27229708.

11. Jonas J.B., Müller-Bergh J.A., Schlötzer-Schrehardt U.M., Naumann G.O. Histomorphometry of the human optic nerve. Invest Ophthalmol Vis Sci. 1990; 31(4): 736–744. PMID: 2335441.

12. Bergland R.M., Ray B.S., Torack R.M. Anatomical variations in the pituitary gland and adjacent structures in 225 human autopsy cases. J Neurosurg. 1968; 28(2): 93–99. https://doi.org/10.3171/jns.1968.28.2.0093. PMID: 5638016.

13. Godement P., Salaün J., Mason C.A. Retinal axon pathfinding in the optic chiasm: divergence of crossed and uncrossed fibres. Neuron. 1990; 5(2): 173–186. https://doi.org/10.1016/0896-6273(90)90307-2. PMID: 2383400.

14. Perez-Leon J.A., Warren E.J., Allen C.N., et al. Synaptic inputs to retinal ganglion cells that set the circadian clock. Eur J Neurosci. 2006; 24(4): 1117–1123. https://doi.org/10.1111/j.1460-9568.2006.04999.x. PMID: 16930437.

15. Morin L.P. Neuroanatomy of the extended circadian rhythm system. Exp Neurol. 2013; 243: 4–20. https://doi.org/10.1016/j.expneurol.2012.06.026. PMID: 22766204.

16. Furlan M., Smith A.T., Walker R. Activity in the human superior colliculus relating to endogenous saccade preparation and execution. J Neurophysiol. 2015; 114(2): 1048–1058. https://doi.org/10.1152/jn.00825.2014. PMID: 26041830.

17. McDougal D.H., Gamlin P.D. Autonomic control of the eye. Compr Physiol. 2015; 5(1): 439–473. https://doi.org/10.1002/cphy.c140014. PMID: 25589275.

18. Denison R.N., Vu A.T., Yacoub E., et al. Functional mapping of the magnocellular and parvocellular subdivisions of human LGN. Neuroimage. 2014; 102 Pt 2(0 2): 358–369. https://doi.org/10.1016/j.neuroimage.2014.07.019. PMID: 25038435.

19. Goga C., Türe U. The anatomy of Meyer’s loop revisited: changing the anatomical paradigm of the temporal loop based on evidence from fibre microdissection. J Neurosurg. 2015; 122(6): 1253–1262. https://doi.org/10.3171/2014.12.JNS14281. PMID: 25635481.

20. Peltier J., Verclytte S., Delmaire C., et al. Microsurgical anatomy of the temporal stem: clinical relevance and correlations with diffusion tensor imaging fibre tracking. J Neurosurg. 2010; 112(5): 1033–1038. https://doi.org/10.3171/2009.6.JNS08132. PMID: 19612976.

21. Bernstein S.L., Meister M., Zhuo J., Gullapalli R.P. Postnatal growth of the human optic nerve. Eye (Lond). 2016 Oct; 30(10): 1378–1380. https://doi.org/10.1038/eye.2016.141. Epub 2016 Jul 15. PMID: 27419835.

22. Selhorst J.B., Chen Y. The optic nerve. Semin Neurol. 2009 Feb; 29(1): 29–35. https://doi.org/10.1055/s-0028-1124020. PMID: 25270138.

23. Jonas J.B., Gusek G.C., Naumann G.O. Optic disc, cup and neuroretinal rim size, configuration and correlations in normal eyes. Invest Ophthalmol Vis Sci. 1988 Jul; 29(7): 1151–1158. Erratum in: Invest Ophthalmol Vis Sci 1991 May; 32(6): 1893. Erratum in: Invest Ophthalmol Vis Sci 1992 Feb; 32(2): 474–475. PMID: 3417404.

24. Oyama T., Abe H., Ushiki T. The connective tissue and glial framework in the optic nerve head of the normal human eye: light and scanning electron microscopic studies. Arch Histol Cytol. 2006 Dec; 69(5): 341–356. https://doi.org/10.1679/aohc.69.341. PMID: 17372390.

25. Balaratnasingam C., Kang M.H., Yu P., et al. Comparative quantitative study of astrocytes and capillary distribution in optic nerve laminar regions. Exp Eye Res. 2014 Apr; 121: 11–22. https://doi.org/10.1016/j.exer.2014.02.008. Epub 2014 Feb 19. PMID: 24560677.

26. Hernandez M.R., Luo X.X., Igoe F., Neufeld A.H. Extracellular matrix of the human lamina cribrosa. Am J Ophthalmol. 1987 Dec 15; 104(6): 567–576. https://doi.org/10.1016/0002-9394(87)90165-6. PMID: 3318474.

27. Perry V.H., Lund R.D. Evidence that the lamina cribrosa prevents intraretinal myelination of retinal ganglion cell axons. J Neurocytol. 1990 Apr; 19(2): 265–272. https://doi.org/10.1007/BF01217304. PMID: 2358833.

28. FitzGibbon T., Nestorovski Z. Human intraretinal myelination: axon diameters and axon/myelin thickness ratios. Indian J Ophthalmol. 2013 Oct; 61(10): 567–575. https://doi.org/10.4103/0301-4738.121075. PMID: 24212308.

29. Onda E., Cioffi G.A., Bacon D.R.., Van Buskirk E.M. Microvasculature of the human optic nerve. Am J Ophthalmol. 1995 Jul; 120(1): 92–102. https://doi.org/10.1016/s0002-9394(14)73763-8. PMID: 7611333.

30. Govsa F., Erturk M., Kayalioglu G., et al. Neuro-arterial relations in the region of the optic canal. Surg Radiol Anat. 1999; 21(5): 329–335. https://doi.org/10.1007/BF01631334. PMID: 10635097.

31. Natori Y., Rhoton A.L.Jr. Transcranial approach to the orbit: microsurgical anatomy. J Neurosurg. 1994 Jul; 81(1): 78–86. https://doi.org/10.3171/jns.1994.81.1.0078. PMID: 8207530.

32. Hokama M., Hongo K., Gibo H., et al. Microsurgical anatomy of the ophthalmic artery and the distal dural ring for the juxta-dural ring aneurysms via the pterional approach. Neurol Res. 2001 Jun; 23(4): 331–335. https://doi.org/10.1179/016164101101198703. PMID: 11428510.

33. Jo-Osvatic A., Basic N., Basic V., et al. Topoanatomic relations of the ophthalmic artery viewed in four horizontal layers. Surg Radiol Anat. 1999; 21(6): 371–375. https://doi.org/10.1007/BF01631344. PMID: 10678729.

34. Kyoshima K., Oikawa S., Kobayashi S. Interdural origin of the ophthalmic artery at the dural ring of the internal carotid artery. Report of two cases. J Neurosurg. 2000 Mar; 92(3): 488–489. https://doi.org/10.3171/10.3171/jns.2000.92.3.0488. PMID: 10701541.

35. Liu Q., Rhoton A.L. Jr. Middle meningeal origin of the ophthalmic artery. Neurosurgery. 2001 Aug; 49(2): 401–406; discussion 406–407. https://doi.org/10.1097/00006123-200108000-00025. PMID: 11504116.

36. Hayreh S.S., Dass R. The ophthalmic artery: II. Intra-orbital course. Br J Ophthalmol. 1962 Mar; 46(3): 165–185. https://doi.org/10.1136/bjo.46.3.165. PMID: 18170768.

37. Rigante L., Evins A.I., Berra L.V., et al. Optic Nerve Decompression through a Supraorbital Approach. J Neurol Surg B Skull Base. 2015 Jun; 76(3): 239–247. https://doi.org/10.1055/s-0034-1543964. Epub 2015 Jan 21. PMID: 26225308.

38. Hayreh S.S. Orbital vascular anatomy. Eye (Lond). 2006 Oct; 20(10): 1130–1144. https://doi.org/10.1038/sj.eye.6702377. PMID: 17019411.

39. Tsutsumi S., Rhoton A.L. Jr. Microsurgical anatomy of the central retinal artery. Neurosurgery. 2006 Oct; 59(4): 870–878; discussion 878–879. https://doi.org/10.1227/01.NEU.0000232654.15306.4A. PMID: 17038951.

40. Blunt M.J., Steele E.J. The blood supply of the optic nerve and chiasma in man. J Anat. 1956 Oct; 90(4): 486–493. PMID: 13366860.

41. Berhouma M., Jacquesson T., Abouaf L., et al. Endoscopic endonasal optic nerve and orbital apex decompression for nontraumatic optic neuropathy: surgical nuances and review of the literature. Neurosurg Focus. 2014; 37(4): E19. https://doi.org/10.3171/2014.7.FOCUS14303. PMID: 25270138.

42. Yang Y., Wang H., Shao Y., et al. Extradural anterior clinoidectomy as an alternative approach for optic nerve decompression: anatomic study and clinical experience. Neurosurgery. 2006 Oct; 59(4 Suppl 2): ONS253-62; discussion ONS262. https://doi.org/10.1227/01.NEU.0000236122.28434.13. PMID: 17041495.

43. Fujii K., Chambers S.M., Rhoton A.L Jr. Neurovascular relationships of the sphenoid sinus. A microsurgical study. J Neurosurg. 1979 Jan; 50(1): 31–39. https://doi.org/10.3171/jns.1979.50.1.0031. PMID: 758376.

44. DeLano M.C., Fun F.Y., Zinreich S.J. Relationship of the optic nerve to the posterior paranasal sinuses: a CT anatomic study. AJNR Am J Neuroradiol. 1996 Apr; 17(4): 669–675. PMID: 8730186.

45. Anand V.K., Sherwood C., Al-Mefty O. Optic nerve decompression via transethmoid and supraorbital approaches. Oper Tech Otolaryngol-Head Neck Surg 1991; 2: 157–166. https://doi.org/10.1016/S1043-1810(10)80049-1

46. Hayek G., Mercier P., Fournier H.D. Anatomy of the orbit and its surgical approach. Adv Tech Stand Neurosurg. 2006; 31: 35–71. https://doi.org/10.1007/10.1007/3-211-32234-5_2. PMID: 16768303.

47. Won H.S., Han S.H., Oh C.S., et al. Topographic variations of the optic chiasm and the foramen diaphragma sellae. Surg Radiol Anat. 2010 Aug; 32(7): 653–657. https://doi.org/10.1007/s00276-010-0661-1. Epub 2010 Apr 8. PMID: 20376451.

48. Griessenauer C.J., Raborn J., Mortazavi M.M., et al. Relationship between the pituitary stalk angle in prefixed, normal, and postfixed optic chiasmata: an anatomic study with microsurgical application. Acta Neurochir (Wien). 2014 Jan; 156(1): 147–151. https://doi.org/10.1007/s00701-013-1944-1. Epub 2013 Nov 28. PMID: 24287682.

49. Schaeffer J.P. Some points in the regional anatomy of the optic pathway, with especial reference to tumors of the hypophysis cerebri and resulting ocular changes. Anat Rec. 1924; 28 (4): 243–279. https://doi.org/10.1002/ar.1090280402

50. Peraio S., Chumas P., Nix P., et al. From above or from below? That is the question. Comparison of the supraorbital approach with the endonasal approach. A cadaveric study. Br J Neurosurg. 2018 Oct; 32(5): 548–552. https://doi.org/10.1080/02688697.2018.1480748. Epub 2018 Jun 6. PMID: 29873260.

51. López-Elizalde R., Robledo-Moreno E., O Shea-Cuevas G., et al. Modified orbitozygomatic approach without orbital roof removal for middle fossa lesions. J Korean Neurosurg Soc. 2018 May; 61(3): 407–414. https://doi.org/10.3340/jkns.2017.0208. Epub 2018 Apr 10. PMID: 29631381.