Thomassin J M, Braccini F, Roche P, Pellet W
C.H.U. Timone, Fédération ORL de la Timone, Service d'ORL et de Chirurgie Cervico-Faciale, Marseille, France.
Rev Laryngol Otol Rhinol (Bord). 1999;120(2):83-7.
Temporal bone venous prolapse with or without meningeal prolapse are a frequent problem in middle ear and labyrinth surgery. 178 translabyrinthine approaches with prolapse study are reported in this retrospective study. Superficially, the approach was narrow in 43% of the patients because of a lateral sinus prolapse in 27 cases or a temporal meningeal prolapse in 50 patients. Surgery was technically difficult in 8 patients with lateral sinus prolapse associated with meningeal prolapse. Deep labyrinth structure reaming was difficult in 40% because of an abnormal position of the jugular bulb and/or the superior petrosal sinus. Both superficial and deep approach was narrow in 22% of the cases. 23 lateral sinus prolapses associated with transhigh jugular bulb and 17 lateral sinus prolapses associated with superior petrosal sinus prolapses were noted and reported. Expectation of these anatomical variations, more frequent on the right side, should be established before surgery with imaging studies in order to perform a safe and efficient surgical procedure.
颞骨静脉脱垂伴或不伴脑膜脱垂是中耳和迷路手术中常见的问题。本回顾性研究报告了178例伴有脱垂的经迷路入路手术。表面上，43%的患者入路狭窄，原因是27例患者出现外侧窦脱垂，50例患者出现颞部脑膜脱垂。8例伴有脑膜脱垂的外侧窦脱垂患者手术操作困难。由于颈静脉球和/或岩上窦位置异常，40%的患者深部迷路结构磨除困难。22%的病例中，表面和深部入路均狭窄。记录并报告了23例与高位颈静脉球相关的外侧窦脱垂和17例与岩上窦脱垂相关的外侧窦脱垂。鉴于这些解剖变异在右侧更为常见，术前应通过影像学检查了解，以便进行安全有效的手术。
