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与人工耳蜗植入相关的耳蜗底转对颈动脉管的压迫

Impingement of the carotid canal on the basal turn of the cochlea as pertaining to cochlear implantation.

作者信息

Singla Anjali, Gupta Tulika, Gupta Ashok Kumar, Aggarwal Anjali, Sahni Daisy

机构信息

*Departments of Anatomy and †Otolaryngology and Head Neck Surgery, Postgraduate Institute of Medical Education and Research, Chandigarh, India.

出版信息

Otol Neurotol. 2014 Dec;35(10):1746-51. doi: 10.1097/MAO.0000000000000471.

Abstract

HYPOTHESIS

To evaluate the relation of the basal turn of the cochlea with the carotid canal as pertaining to cochlear implantation.

BACKGROUND

Cochlear implantation is an established mode of treatment for patients with bilateral profound sensorineural hearing loss. An intricate knowledge of both the typical and atypical topography of the cochlea with the carotid canal is essential for safely conducting cochlear implantation.

DESIGN

Fifty-eight cadaveric temporal bones were microdissected to expose the medial wall of the middle ear. To open the basal turn of the cochlea, the promontory was drilled. The carotid canal was unroofed to reveal the internal carotid artery. The minimum distance between the basal turn of the cochlea and the vertical part of the carotid canal was measured.

RESULTS

The minimum distance between the basal turn of the cochlea and the carotid canal ranged from 0 to 3.9 mm (mean ± SD, 1.3 ± 0.8 mm). The carotid canal was abutting the basal turn of the cochlea in three cases, and impingement of the carotid canal on the anterior cochlear wall was found in five (8.6%) cases.

CONCLUSION

Preoperative knowledge of findings like impingement (8.6%) and abutment (5.2%) of the carotid canal on the basal turn of the cochlea is of immense importance in cochlear implantation, which may otherwise lead to disastrous consequences during surgery.

摘要

假设

评估耳蜗底转与颈动脉管的关系,以用于人工耳蜗植入。

背景

人工耳蜗植入是双侧极重度感音神经性听力损失患者既定的治疗方式。全面了解耳蜗与颈动脉管的典型及非典型解剖结构对于安全进行人工耳蜗植入至关重要。

设计

对58具尸体颞骨进行显微解剖以暴露中耳内侧壁。通过磨除岬部打开耳蜗底转。去除颈动脉管顶壁以显露颈内动脉。测量耳蜗底转与颈动脉管垂直部分之间的最小距离。

结果

耳蜗底转与颈动脉管之间的最小距离为0至3.9毫米(均值±标准差,1.3±0.8毫米)。3例中颈动脉管紧邻耳蜗底转,5例(8.6%)发现颈动脉管对耳蜗前壁有压迫。

结论

术前了解如颈动脉管对耳蜗底转的压迫(8.6%)和紧邻(5.2%)等情况,对人工耳蜗植入极为重要,否则手术中可能导致灾难性后果。

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