Effect of transposition surgery on rectus muscle paths by magnetic resonance imaging.
Effect of transposition surgery on rectus muscle paths by magnetic resonance imaging.
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DOI：
10.1016/s0161-6420(93)31618-0
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发表时间：
1993-04
期刊：
影响因子：
13.7
通讯作者：
Joel Miller;J. Demer;A. Rosenbaum
中科院分区：
文献类型：
--
作者：
Joel Miller;J. Demer;A. Rosenbaum
目的：探讨眼外肌转位对眼眶中深部肌群的影响。方法：采用表面线圈磁共振成像(MRI)技术，对5例眼外直肌转位手术前后进行对比观察，评价不同术式的效果。结果：垂直肌移位6~10 mm时，眼球赤道后方的肌肉路径变化小于或等于3 mm。大到10 mm的外直肌转位导致肌腹几乎没有运动。传统模型预测的变化要大得多。结论：作者观察到的直肌腹部相对于眼眶壁的运动少于传统假设下的预期，即转位肌肉遵循从起始到附着点的最短路径。这意味着眼眶中部和深层组织(结缔组织和分隔的眼眶脂肪)限制了直肌腹壁的路径，使它们无法自由滑动以跟随其转位的止点。作者认为，这些组织的功能是弹性连接到眼眶壁的“滑轮”，它们是眼外肌功能的重要决定因素。
Purpose:To evaluate effects of transposition on extraocular rectus muscle paths in middle and deep orbit.Methods:The effect of various transposition procedures was assessed in five patients, using surface coil magnetic resonance imaging (MRI), performed with controlled gaze before and after surgery. Path changes were compared with those expected under conventional concepts of functional orbital anatomy, quantified by biomechanical modeling.Results:Vertical rectus transpositions of 6 to 10 mm produced changes in muscle paths of 3 mm or less, assessed posterior to the equator of the globe. Lateral rectus transpositions as large as 10 mm resulted in almost no movement of muscle bellies. .Conventional modeling predicted much larger changes.Conclusion:The authors observed less movement of rectus muscle bellies relative to orbital walls than would be expected under the traditional assumption that transposed muscles follow the shortest path from origin to insertion. This implies that middle and deep orbital tissues (connective tissues and compartmentalized orbital fat) constrain the paths of rectus muscle bellies, preventing them from sliding freely to follow their transposed insertions. The authors propose that these tissues function as "pulleys" elastically coupled to the orbital wall, and that they are important determinants of extraocular muscle function.