摘要
目的探讨经乳突面隐窝入路后鼓室人路的相关解剖,进行观察测量,为该入路手术提供解剖学资料。方法成人头颅福尔马林泡过6例12侧,在放大10倍的手术显微镜下模拟中耳乳突面隐窝后鼓室入路手术,观察和测量了外耳道上棘、面神经、面隐窝、锥隆起、圆窗、卵圆窗,岬小桥、岬后脚、等相关的解剖结构,数据进行统计学处理。结果外耳道上棘至砧骨短脚的平均距离为20.06mm,外耳道上棘至面神经锥段中点平均距离为17.28 mm,面神经锥段中点距外耳道后壁垂直距离平均为4.67mm,面神经水平段平均长12.30 mm,面神经垂直段平均长16.31 mm.面神经水平段与垂直段的夹角平均为111.5°,鼓索神经与面神经垂直段的夹角平均为23.9°锥隆起至圆窗龛的平均距离为4.46 mrn,锥隆起到镫骨头平均距离2.62mm,锥隆起到砧骨窝平均距离4.43mm,卵圆窗至圆窗龛的平均距离为3.84mm,砧镫关节至圆窗龛的平均距离为3.89mm面神经锥段中点到卵圆窗平均距离8.10mm;面神经锥段中点到岬小桥与岬下脚下端的距离分别是(4.85±0.45mm),(6.21±0.52mm);鼓索神经和面神经垂直段夹角平均为48.3°,水平半规管与面神经水平段夹角平均为19.5°,面神经水平段与垂直段夹角平均为111.5°。结论中耳乳突入路手术中部分重要解剖结构位置恒定,重要解剖结构间距离及角度在一定范围内变化,熟悉其解剖关系,可以完全的清楚病变,又可以指导临床手术,避免手术损伤。
Objective To provide the anatomic data for operation on the posterior tympanum through the transmastoid facial recess approach and measurement of related anatomic structure. Method 12 sides of 6 temporals had their mastoids outlined and removing the latend wall of external auditory canal by an electric drill, and then the related structure of the posterior tympanum was exposed under surgical micmscope. Observation and Measurement of the suprameatal spine, facial nerve, fa- cial recess, pyramidal eminence, round window, oval window measured, ponticulus, pseudosubiculum andother related anatomical structure, statistical datas which were statistically analyzed. Result The average distances from auprameatal spine to short erus incus, The midpoint of pyramid segment of facial nerve canal were 20.06mm, 17.28 mm, respectively. The average distances from the midpoint of pyramid segment of facial canal to the posterior wall of external auditory canal was 4.67mm; The average length of facial nerve in the horizonial segment, the perpendicular paragraph was about 12.30mm, 16.31mm, re- spectively. The average distance from pyramidal eminence to the anterior lip of round window niche, from oval window to round window niche ,from ineudostapedial joint to round window niche was 4.46 mm, 3.84mm, 3.89 mm, espectively. The average distancs from the midpointof pyramid segment of facial canal to the lower endof the ponticulus, the lower end of the pseu- dosubieulum were 4.85mm, and 6.21mm respectively, chorda tympani nerve with facial nerve in the perpendicular paragraph was 48.3°,horizontal semicircular canal and facial nerve in the level paragraph was110. 5°. Conclusion The position of anatomic structure in middle ear was constant and the relationship including distance and angle between anatomic structures changed in limited region. The anatomical parameters provide a reference value for avoiding the injury during the operation.
出处
《中华耳科学杂志》
CSCD
北大核心
2014年第1期116-118,共3页
Chinese Journal of Otology
基金
广东省自然科学基金
(S2011040005318)
南方医科大学第三附属医院院长基金
(A200901)
关键词
中耳
后鼓室
面隐窝
应用解剖学
Middle ear
Posterior tympanum
Facial recess
Applied anatomy
