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[经面神经隐窝入路的解剖学测量及临床应用]

[Anatomical measurements and clinical applications through facial recess approach].

作者信息

Wang Huibing, Shan Xizheng, Meng Zhaojin, Sun Hanjun, Zhao Longzhu

机构信息

Department of Otolaryngology-Head and Neck Surgery, General Hospital of Chinese People's Armed Police Forces, Beijing 100039, China.

出版信息

Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2013 Jul;27(13):708-11.

Abstract

OBJECTIVE

To provide the anatomic data for the correlated otologic microsurgery by the microdissection of temporal bone through facial recess approach.

METHOD

Sixteen human temporal bones of eight adult cadaveric heads were dissected under surgical microscope through facial recess approach, and the relative anatomic structures were observed and measured, such as the bony entrance of facial recess approach, facial nerve, stapes, round window, round window niche, pyramidal eminence, cochleariform process, etc. The data were analyzed statistically.

RESULT

The width of the bony entrance of facial recess approach was (2.94 +/- 0.32) mm, the height was (8.83 +/- 0.84) mm, the depth was (3.51 +/- 0.17) mm. The distances from stapes to tympanic segment of facial nerve, mastoid segment of facial nerve, round window, cochleariform process and anterior ligament of malleus were (1.38 +/- 0.21) mm, (6.94 +/- 0.47) mm, (3.60 +/- 0.55)mm, (2.23 +/- 0.33)mm, (4.93 +/- 0.61) mm, respectively. The distances from pyramidal eminence to tympanic segment of facial nerve, mastoid segment of facial nerve, round window, round window niche and cochleariform process were (1.05 +/- 0.09) mm, (5.63 +/- 0.41) mm, (3.01 +/- 0.34) mm, (3.29 +/- 0.44) mm, (4.13 +/- 0.51) mm, respectively. The distances from round window to cochleariform process and tympanic segment of facial nerve were (5.11 +/- 0.61) mm and (3.97 +/- 0.61) mm. The distances from round window niche to tympanic segment of facial nerve and mastoid segment of facial nerve were (4.13 +/- 0.38) mm and (7.28 +/- 0.29) mm.

CONCLUSION

The facial recess approach played an important role in modern otologic microsurgery. The position of anatomical structure was constant relatively, including short crus of incus, stapes, pyramidal eminence and cochleariform process, etc. These could be used as reference marks for otologic microsurgery.

摘要

目的

通过经面神经隐窝入路对颞骨进行显微解剖,为相关耳科显微手术提供解剖学数据。

方法

在手术显微镜下经面神经隐窝入路对8个成人尸体头颅的16侧颞骨进行解剖,观察并测量面神经隐窝入路的骨性入口、面神经、镫骨、圆窗、圆窗龛、锥隆起、匙突等相关解剖结构,对数据进行统计学分析。

结果

面神经隐窝入路的骨性入口宽度为(2.94±0.32)mm,高度为(8.83±0.84)mm,深度为(3.51±0.17)mm。镫骨到面神经鼓室段、面神经乳突段、圆窗、匙突及锤骨前韧带的距离分别为(1.38±0.21)mm、(6.94±0.47)mm、(3.60±0.55)mm、(2.23±0.33)mm、(4.93±0.61)mm。锥隆起到面神经鼓室段、面神经乳突段、圆窗、圆窗龛及匙突的距离分别为(1.05±0.09)mm、(5.63±0.41)mm、(3.01±0.34)mm、(3.29±0.44)mm、(4.13±0.51)mm。圆窗到匙突及面神经鼓室段的距离分别为(5.11±0.61)mm和(3.97±0.61)mm。圆窗龛到面神经鼓室段及面神经乳突段的距离分别为(4.13±0.38)mm和(7.28±0.29)mm。

结论

面神经隐窝入路在现代耳科显微手术中发挥着重要作用。包括砧骨短脚、镫骨、锥隆起及匙突等在内的解剖结构位置相对恒定,可为耳科显微手术提供参考标志。

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