Shane Tubbs R, Hose Nicole, Loukas Marios, De Caro Raffaele, Cohen-Gadol Aaron A
Seattle Science Foundation, Seattle, WA, USA.
Department of Anatomical Sciences, St. George's University, True Blue, Grenada.
Surg Radiol Anat. 2016 Jul;38(5):619-23. doi: 10.1007/s00276-015-1571-z. Epub 2015 Oct 15.
Unexpected clinical outcomes following transection of single nerves of the internal acoustic meatus have been reported. Therefore, this study aimed to investigate interneural connections between the nervus intermedius and the adjacent nerves in the cerebellopontine angle.
On 100 cadaveric sides, dissections were made of the facial/vestibulocochlear complex in the cerebellopontine angle with special attention to the nervus intermedius and potential connections between this nerve and the adjacent facial or vestibulocochlear nerves.
A nervus intermedius was identified on all but ten sides. Histologically confirmed neural connections were found between the nervus intermedius and either the facial or vestibulocochlear nerves on 34 % of sides. The mean diameter of these small interconnecting nerves was 0.1 mm. The fiber orientation of these nerves was usually oblique (anteromedial or posterolateral) in nature, but 13 connections traveled anteroposteriorly. Connecting fibers were single on 81 % of sides, doubled on 16 %, and tripled on 3 %, six sides had connections both with the facial nerve anteriorly and the vestibular nerves posteriorly. On 6.5 % of sides, a connection was between the nervus intermedius and cochlear nerve. For vestibular nerve connections with the nervus intermedius, 76 % were with the superior vestibular nerve and 24 % with the inferior vestibular nerve.
Knowledge of the possible neural interconnections found between the nervus intermedius and surrounding nerves may prove useful to surgeons who operate in these regions so that inadvertent traction or transection is avoided. Additionally, unanticipated clinical presentations and exams following surgery may be due to such neural interconnections.
已有报道称，内耳道单根神经横断后会出现意外的临床结果。因此，本研究旨在调查中间神经与桥小脑角相邻神经之间的神经内连接。
在100侧尸体标本上，对桥小脑角的面/前庭蜗复合体进行解剖，特别关注中间神经以及该神经与相邻面神经或前庭蜗神经之间的潜在连接。
除10侧外，其余各侧均识别出中间神经。在34%的侧别中，组织学证实中间神经与面神经或前庭蜗神经之间存在神经连接。这些细小的互连神经的平均直径为0.1毫米。这些神经的纤维方向通常为斜行（前内侧或后外侧），但有13条连接呈前后走行。81%的侧别连接纤维为单根，16%为双根，3%为三根，6侧在前方与面神经、后方与前庭神经均有连接。在6.5%的侧别中，中间神经与蜗神经之间存在连接。在前庭神经与中间神经的连接中，76%与上前庭神经相连，24%与下前庭神经相连。
了解中间神经与周围神经之间可能存在的神经互连，可能对在这些区域进行手术的外科医生有用，从而避免意外牵拉或横断。此外，手术后意外的临床表现和检查结果可能归因于这种神经互连。
