GOAL The location and anatomical relationships of the superior oblique muscle make surgical intervention difficult. The aim of the present paper was therefore to supplement existing anatomical descriptions of this muscle. Its anatomical variability is particularly emphasized, including variations in muscle and tendon size and details of the innervation pattern. MATERIALS AND METHODS The study was conducted on 78 orbits from 39 adult human cadavers of both sexes (18 males and 21 females). The roof and upper part of the medial and lateral walls of the orbit were carefully removed, which allowed the superior oblique muscle and trochlear nerve to be exposed along their entire course. Sihler's stain was applied to visualize the intramuscular distribution of the trochlear nerve. RESULTS The length of the muscle between the origin and trochlea ranged from 37.8 to 56.5mm, the length of the tendinous expansion ranged from 16.3 to 22.8mm, and the width of the scleral insertion of the muscle's tendon ranged from 5.4 to 9.6mm. In two cadavers, accessory muscular slips connecting the levator palpebrae superioris muscle to the trochlea of the superior oblique muscle were present unilaterally. The distance from the level of the trochlea attachment to the anteriormost endings of the intramuscular branches varied from 17.2 to 21.5mm. CONCLUSIONS The intramuscular nervous branches of the trochlear nerve form a tree-like pattern. Unexpected anatomical variations such as accessory muscular bands could be relevant during orbital imaging or surgeries.

中文翻译：

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上斜肌的解剖学变化和神经支配方式。

目标上斜肌的位置和解剖关系使外科手术变得困难。因此，本论文的目的是补充该肌肉的现有解剖学描述。特别强调其解剖变异性，包括肌肉和肌腱大小的变异以及神经支配模式的细节。材料与方法这项研究是从39个男女成年尸体（男18例，女21例）的78个轨道上进行的。小心地去除了眼眶内侧和侧壁的顶部和上部，使上斜肌和滑车神经沿整个过程暴露。席勒氏染色用于可视化滑车神经的肌内分布。结果原发与滑车之间的肌肉长度在37.8至56.5mm之间，肌腱扩张的长度在16.3至22.8mm之间，而肌腱的巩膜插入宽度在5.4至9.6mm之间。在两个尸体中，单侧出现了将上睑提肌和上斜肌的滑车相连的副肌滑倒。从滑车附着水平到肌内分支最前端的距离从17.2到21.5mm不等。结论滑车神经的肌内神经分支形成树状图案。在眼眶成像或手术过程中可能会出现意外的解剖变化，例如副肌带。3至22.8mm，肌肉腱的巩膜插入宽度为5.4至9.6mm。在两个尸体中，单侧出现了将上睑提肌和上斜肌的滑车相连的副肌滑倒。从滑车附着水平到肌内分支最前端的距离从17.2到21.5mm不等。结论滑车神经的肌内神经分支形成树状图案。在眼眶成像或手术过程中，意外的解剖变化（如辅助性肌肉带）可能是相关的。3至22.8mm，肌肉腱的巩膜插入宽度为5.4至9.6mm。在两个尸体中，单侧出现了将上睑提肌和上斜肌的滑车相连的副肌滑倒。从滑车附着水平到肌内分支最前端的距离从17.2到21.5mm不等。结论滑车神经的肌内神经分支形成树状图案。在眼眶成像或手术过程中可能会出现意外的解剖变化，例如副肌带。单侧出现将上睑提肌和上斜肌滑车相连的辅助肌滑道。从滑车附着水平到肌内分支最前端的距离从17.2到21.5mm不等。结论滑车神经的肌内神经分支形成树状图案。在眼眶成像或手术过程中，意外的解剖变化（如辅助性肌肉带）可能是相关的。单侧出现将上睑提肌和上斜肌滑车相连的辅助肌滑道。从滑车附着水平到肌内分支最前端的距离从17.2到21.5mm不等。结论滑车神经的肌内神经分支形成树状图案。在眼眶成像或手术过程中，意外的解剖变化（如辅助性肌肉带）可能是相关的。