Takahashi H, Sando I
Elizabeth McCullough Knowles Otopathology Laboratory, Department of Otolaryngology, University of Pittsburgh School of Medicine, Pa.
Laryngoscope. 1992 Oct;102(10):1159-64. doi: 10.1288/00005537-199210000-00011.
To define anatomical relationships relevant to stapes surgery, computer-aided three-dimensional reconstruction and measurement were performed on nine normal temporal bones. The mean distance from the inferior portion of the long process of the incus to the center of the oval window was 3.80 mm. The shortest distance from the center of the oval window to the utricular macula, saccular membrane, and macula averaged 1.37, 1.60, and 2.13 mm. Surgery directed posteromedial-superior from the oval window was found to be most dangerous because it would come so close to the utricular macula; a posteromedial-inferior approach was found to be safest. The distance from the inferior margin of the oval window inferiorly to the cochlear duct in the hook portion ranged between 0.58 and 1.29 mm, suggesting that when a drill hole is made on the inferior margin of the oval window to lift up a depressed stapes footplate, the hole should not be greater than 0.5 mm in diameter.
为明确与镫骨手术相关的解剖关系，对9个正常颞骨进行了计算机辅助三维重建和测量。砧骨长突下部至椭圆窗中心的平均距离为3.80毫米。椭圆窗中心至椭圆囊斑、球囊膜和黄斑的最短距离平均分别为1.37、1.60和2.13毫米。发现从椭圆窗向内侧后上方进行手术最为危险，因为这样会非常接近椭圆囊斑；而向内侧后下方入路则最为安全。椭圆窗下缘至钩部蜗管的距离在0.58至1.29毫米之间，这表明当在椭圆窗下缘钻孔以抬起下陷的镫骨底板时，钻孔直径不应大于0.5毫米。
