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[玻璃样变的鼓索神经管在中耳手术中对面神经乳突段的保护作用]

[The effect of hyalinized chorda tympani nerve canal in protection of mastoid segment of facial nerve in middle ear surgery].

作者信息

Hong Yongjun, Ma Yanli, Zhuang Peiyun, Xu Xinlin

机构信息

Department of Otolaryngology, Zhongshan Hospital of Xiamen University, Xiamen, 361004, China.

出版信息

Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2013 May;27(10):487-90.

Abstract

OBJECTIVE

To investigate the effect of hyalinized chorda tympani nerve canal in mastoid segment to landmark facial nerve in middle ear surgery by means of observing the location relationship between hyalinized chorda tympani nerve canal and facial nerve.

METHOD

118 cases of cholesteatoma otitis media in our hospital undergoing tympanoplasty from 2008 to 2011 were retrospectively analyzed. In all the cases, the position of horizontal semicircular and fossa incus as well as the hyalinized chorda tympani nerve canal were used for landmark the height of facial ridge and vertical segment of facial nerve.

RESULT

The chorda tympani nerve of 99 patients were higher than the vertical segment of the facial nerve which were not exposed, and the vertical segment of the facial nerve in 9 patients, which were exposed, were 1-2 mm lower and 2-3 mm ahead or backward than the chorda tympani nerve. The horizontal semicircular and fossa incus were broken in 9 patients, of whom the vertical segments of the facial nerve were 1-2 mm lower and 2-3 mm ahead or backward than the chorda tympani nerve. The chorda tympani nerve of 1 patient were lower than the exposed vertical segment of facial nerve.

CONCLUSION

The hyalinized chorda tympani nerve canal in mastoid segment can landmark the positon of facial ridge, and it would be the complement to the traditional method of landmarking vertical segment of facial nerve, especially for those whose horizontal semicircular canal and fossa incus had been broken.

摘要

目的

通过观察玻璃样变的鼓索神经乳突段与面神经的位置关系,探讨其在中耳手术中对面神经定位的作用。

方法

回顾性分析2008年至2011年在我院行鼓室成形术的118例胆脂瘤型中耳炎患者。所有病例均以水平半规管、砧骨窝及玻璃样变的鼓索神经乳突段为标志,确定面神经嵴及面神经垂直段的高度。

结果

99例患者的鼓索神经高于未暴露的面神经垂直段,9例暴露的面神经垂直段比鼓索神经低1 - 2mm,前后移位2 - 3mm。9例患者水平半规管及砧骨窝破坏,其面神经垂直段比鼓索神经低1 - 2mm,前后移位2 - 3mm。1例患者的鼓索神经低于暴露的面神经垂直段。

结论

乳突段玻璃样变的鼓索神经可对面神经嵴进行定位,是对面神经垂直段传统定位方法的补充,尤其适用于水平半规管及砧骨窝破坏的患者。

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