Li Peter M M C, Wang Haobing, Northrop Clarinda, Merchant Saumil N, Nadol Joseph B
Department of Otology and Laryngology, Harvard Medical School/Massachusetts Eye and Ear Infirmary, Boston, Massachusetts 02114, USA.
Otol Neurotol. 2007 Aug;28(5):641-8. doi: 10.1097/mao.0b013e3180577949.
The goal of this study was to create a three-dimensional model of the anatomy of the hook region to identify the optimal site for cochleostomy in cochlear implant surgery.
The anatomy of the hook region is complex, and spatial relationships can be difficult to evaluate using two-dimensional histological slides or cadaveric temporal bones.
The right temporal bone of a 14-year-old adolescent boy was used to create a three-dimensional model. Sections containing the round window membrane (RWM) and surrounding cochlear structures were stained, digitized, and imported into a general purpose three-dimensional rendering and analysis software program (Amira, version 4.1). Three-dimensional models of the RWM, basilar membrane, osseous spiral lamina, spiral ligament, cochlear aqueduct, inferior cochlea vein, scala media, ductus reuniens, scala vestibuli, scala tympani, and surrounding bone were generated. The relationship between these structures and the RWM and adjacent otic capsule was evaluated. Histological sections from a different temporal bone were also analyzed. This temporal bone was sectioned in a plane perpendicular to the axis corresponding to the surgical view of the RWM, seen through the facial recess.
The anteroinferior margin of the RWM or adjacent otic capsule was identified as the site for a cochleostomy that will avoid damage to critical cochlear structures and allow implantation directly into the scala tympani. The model can be downloaded from: https://research.meei.harvard.edu/otopathology/3dmodels.
This three-dimensional model has implications for surgical procedures to the inner ear that aim to minimize insertional trauma.
本研究的目的是创建一个钩状区域的三维解剖模型，以确定人工耳蜗植入手术中最佳的蜗窗造口位置。
钩状区域的解剖结构复杂，使用二维组织切片或尸体颞骨难以评估其空间关系。
使用一名14岁青少年男性的右侧颞骨创建三维模型。对包含圆窗膜（RWM）及周围耳蜗结构的切片进行染色、数字化处理，然后导入通用的三维渲染和分析软件程序（Amira，版本4.1）。生成了RWM、基底膜、骨螺旋板、螺旋韧带、蜗水管、蜗下静脉、中阶、连合管、前庭阶、鼓阶以及周围骨质的三维模型。评估了这些结构与RWM及相邻耳囊之间的关系。还分析了取自另一个颞骨的组织学切片。该颞骨在与通过面神经隐窝观察到的RWM手术视野相对应的轴垂直的平面上进行切片。
RWM或相邻耳囊的前下缘被确定为蜗窗造口的位置，该位置可避免损伤关键的耳蜗结构，并允许直接植入鼓阶。该模型可从以下网址下载：https://research.meei.harvard.edu/otopathology/3dmodels。
这个三维模型对旨在尽量减少插入性创伤的内耳手术操作具有指导意义。
