Anagnostopoulou S, Diamantopoulou P
Department of Anatomy Medical School, University of Athens, 75 M. Asias Street, 11527 Goudi, Athens, Greece.
Surg Radiol Anat. 2004 Apr;26(2):82-5. doi: 10.1007/s00276-003-0196-9. Epub 2003 Oct 25.
The cochlea has attained extreme surgical interest since cochlear implantation has been recognized as an established method for the management of certain types of bilateral profound hearing loss. Traditionally access to the cochlear turns is achieved through the middle ear. Extremely limited references exist in the literature regarding alternative surgical approaches to the cochlea. In the present study we tried to highlight the anatomic relationships of the superior aspect of the bony cochlea to the adjacent superficial structures of the petrous bone, as there have been suggestions that the cochlea is surgically accessible through the floor of the middle cranial fossa (MCF). A total of 58 dry human adult skulls (116 temporal bones) were studied. The groove for the greater superficial petrosal nerve (GGSPN) and the facial hiatus were used as landmarks in order to expose the superior aspect of the cochlea. Measurements were made of the following distances: a) between the MCF floor and the superficial part of the basal turn (SPBT), b) between the MCF floor and the apex of the cochlea, c) between the SPBT and the GGSPN and d) between the SPBT medially and the first genu of the facial canal laterally. Our results indicate that adequate and reliable surgical access to the bony cochlea could be achieved through the MCF floor.
自从人工耳蜗植入被公认为是治疗某些类型双侧重度听力损失的既定方法以来，耳蜗已引起了极大的外科手术关注。传统上，通过中耳进入耳蜗螺旋。关于耳蜗的替代手术入路，文献中存在的参考极为有限。在本研究中，我们试图突出骨迷路耳蜗上方与岩骨相邻浅表结构的解剖关系，因为有人提出可以通过中颅窝（MCF）底部进行耳蜗手术。共研究了58个成人干燥人类头骨（116块颞骨）。以岩浅大神经沟（GGSPN）和面神经管裂孔为标志，以暴露耳蜗的上方。测量了以下距离：a）中颅窝底部与蜗底浅层（SPBT）之间的距离，b）中颅窝底部与耳蜗尖之间的距离，c）SPBT与GGSPN之间的距离，以及d）内侧SPBT与外侧面神经管第一膝之间的距离。我们的结果表明，通过中颅窝底部可以实现对骨迷路耳蜗的充分且可靠的手术入路。
