Takahashi H, Sando I
Department of Otolaryngology, University of Pittsburgh School of Medicine, PA 15213.
Eur Arch Otorhinolaryngol. 1992;249(2):74-8. doi: 10.1007/BF00186450.
A computer reconstruction method was used to study five normal temporal bones for the three-dimensional anatomy necessary for singular neurectomy. The length of the singular canal was 4.9 +/- 0.6 mm. The distal portion of the singular canal courses at a sharp angle (48.2 degrees) to the direction of the transmeatal surgical approach for this operation. The reconstructions indicated that the singular canal can be exposed by introducing a drill through the external auditory meatus at a point 0.71 mm posteroinferior to the posteromedial margin of the round window on the saucerized medial wall of the round window niche. The distance from this site to the distal end-portion of the singular canal averaged 1.47 mm. The point on the drilling course (from the drilling site to the singular canal) closest to the vestibular end of the hook portion of the cochlea was 0.48-1.00 mm from the drilling site. The reconstructions also indicated that the dissection should proceed superomedially, if necessary, after a 1-mm-deep straight dissection along the transmeatal approach. The ampulla of the posterior semicircular canal, cochlear aqueduct and inferior cochlear vein were all found to lie within 2 mm of the drilling point.
采用计算机重建方法对5例正常颞骨进行研究，以获取单神经切除术所需的三维解剖结构。单管的长度为4.9±0.6mm。单管的远端部分与该手术经耳道手术入路的方向呈锐角（48.2度）走行。重建结果表明，通过在圆窗龛碟形内侧壁上圆窗后内侧缘后下方0.71mm处经外耳道插入钻头，可暴露单管。该部位到单管远端的平均距离为1.47mm。钻孔路径（从钻孔部位到单管）上最接近耳蜗钩部前庭端的点距离钻孔部位0.48 - 1.00mm。重建结果还表明，沿经耳道入路进行1mm深的直线解剖后，如有必要，解剖应向上内侧进行。后半规管壶腹、蜗水管和蜗下静脉均位于距钻孔点2mm范围内。
