Regional Anatomy And Three-dimensional Visualization Of The Organizational Structure Of Medial Canthus Area

Objective By using regional anatomy and measurement to obtain the morphological datas of Chinese lacrimal canaliculus.To observe the microstructure of the canthus and study the three-dimensional spatial distribution and adjacent relationship of lacrimal canaliculus and its surrounding structures by serial tissue sections.Method 12 sides adult inner canthus specimens were randomly divided into 3 groups.The anterior approach,the lacrimal duct cast and the posterior approach were used to expose and display the lacrimal canaliculus.To explore and improve the dissection method of lacrimal canaliculus specimen.52 lateral canthus specimens were dissected by the posterior approach to observe the morphological characteristics of lacrimal passages and at the same time to measure the length,diameter and angle of the lacrimal passages.The diameter of the orbit were measured and tested with the length of horizontal part of lacrimal canaliculus.Three cases of adult Chinese canthus were selected.All cases were embedded paraffin and sliced.That slices were stained with H-E or MASSON and photographed use microscopes.Finally,the three-dimensional was reconstructed in computer with 3D-DOCTOR software.Result(1)The results of anatomical method showed that the posterior approach was performed on 56 sides specimens and showed 51 sides.The success rate was significantly higher than the other two methods.(2)The results of lacrimal duct data measurement: The length of the vertical canaliculus and horizontal canaliculus of upper canaliculus ? vertical canaliculus and horizontal canaliculus of inferior canaliculus and common canaliculus of male were respectively(2.77±0.05)?(9.51±0.11)?(2.56±0.04)?(9.57±0.12)?(2.11±0.08)mm;The length of the vertical canaliculus and horizontal canaliculus of upper canaliculu?vertical canaliculus and horizontal canaliculus of inferior canaliculus and common canaliculus of famale were respectively(2.78±0.10)?(9.75±0.10)?(2.88±0.09)?(9.74±0.10)?(2.73±0.31)mm;In 91.5%,the upper and lower lacrimal canaliculis converge to form the common canaliculus,however in 8.5% were opened together in the lacrimal sac.(3)Orbital diameter and horizontal canaliculus length correlation test was statistically significant results,L2 and canalicular level(r=0.378,P < 0.05),L2 and canalicular level(r=0.325,P < 0.05),L3 and canalicular level(r=0.378,P < 0.05),L4 and on the canalicular level(r=0.298,P < 0.05),L6 and canalicular level(r=0.340,P < 0.05),other diameter and canalicular length dependence was not statistically significant.(4)Slice and 3D modeling results: stratified squamous epithelium of lacrimal duct and lacrimal duct lining not keratinized,lacrimal sac lined with stratified columnar epithelium,fiber canaliculus around roughly divided into dense fibers near the basal cell layer and surrounding lacrimal canaliculus;the middle fiber is loose,three layer oblique surround canaliculus the outermost layer of fiber;vertical lacrimal canaliculus between surrounding muscle fibers was below the skin and conjunctiva and reticular fibers connected;the front tarsal orbicularis muscle fibers divided into superficial and deep ends,were walking in the front and rear canaliculus,superficial head from the medial canthal ligament anterior,walk the line parallel to the canalicular Horner muscle originates from the medial canthal ligament posterior,lateral oblique forward gradually,the final two deep and superficial muscle fibers in the upper lacrimal duct below the confluence and lacrimal duct,become the orbicularis muscle anterior tarsal muscle fiber Dimension,walk to the temporal side in front of the ampulla of the lacrimal canaliculus.Conclusions 1.The posterior approach anatomy can reduce the injury of the lacrimal canaliculus and present the whole pictures of the lacrimal canaliculus.2.The length of the horizontal part of the upper and lower lacrimal canaliculi is related to the length of multiple orbiculari.3.The three-dimensional structure of the soft tissue in the inner canthus region is reconstructed by continuous thin slice,which provide a model for the morphological study,the lacrimal canaliculus operation design and the regional surgery.