1Department of Neurosurgery/Neuro-Oncology, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, People's Republic of China.
4Department of Neurosurgery, University of Florida, Gainesville, Florida.
J Neurosurg. 2016 Nov;125(5):1-11. doi: 10.3171/2015.8.JNS151325. Epub 2016 Jan 29.
OBJECTIVE The object of this study was to examine the relationships of the cochlea as a guide for avoiding both cochlear damage with loss of hearing in middle fossa approaches and injury to adjacent structures in approaches directed through the cochlea. METHODS Twenty adult cadaveric middle fossae were examined using magnifications of ×3 to ×40. RESULTS The cochlea sits below the floor of the middle fossa in the area between and below the labyrinthine segment of the facial nerve and greater petrosal nerve (GPN) and adjacent to the lateral genu of the petrous carotid. Approximately one-third of the cochlea extends below the medial edge of the labyrinthine segment of the facial nerve, geniculate ganglion, and proximal part of the GPN. The medial part of the basal and middle turns are the parts at greatest risk in drilling the floor of the middle fossa to expose the nerves in middle fossa approaches to the internal acoustic meatus and in anterior petrosectomy approaches. Resection of the cochlea is used selectively in extending approaches through the mastoid toward the lateral edge of the clivus and front of the brainstem. CONCLUSIONS An understanding of the location and relationships of the cochlea will reduce the likelihood of cochlear damage with hearing loss in approaches directed through the middle fossa and reduce the incidence of injury to adjacent structures in approaches directed through the cochlea.
本研究旨在探讨通过中颅窝入路时，以耳蜗作为指导，避免耳蜗损伤和听力丧失，以及通过耳蜗入路时避免损伤相邻结构的关系。
使用放大倍数为×3 至×40 的方法对 20 例成人尸体中颅窝进行检查。
耳蜗位于面神经和岩大神经（GPN）迷路段下方和外侧之间以及颈动脉岩骨外侧支附近的中颅窝底部。大约三分之一的耳蜗延伸到面神经迷路段、膝状神经节和 GPN 近端的内缘以下。在中颅窝入路暴露内听道和前岩骨切除术入路的神经以及在中颅窝底部钻孔时，基底和中回的内侧部分是最容易受损的部位。选择性切除耳蜗可通过乳突向斜坡外侧边缘和脑干前方扩展入路。
了解耳蜗的位置和关系将降低通过中颅窝入路时耳蜗损伤和听力丧失的可能性，并降低通过耳蜗入路时损伤相邻结构的发生率。
