Ikeda Ryoukichi, Hidaka Hiroshi, Murata Takaki, Miyazaki Hiromitsu, Katori Yukio, Kobayashi Toshimitsu
Sen-En Rifu Otologic Surgery Center, Miyagi-gun, Miyagi, Japan; Department of Otolaryngology-Head and Neck Surgery, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan.
Department of Otolaryngology-Head and Neck Surgery, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan.
Auris Nasus Larynx. 2019 Apr;46(2):204-209. doi: 10.1016/j.anl.2018.08.012. Epub 2018 Sep 7.
A method of Vibrant Soundbridge (VSB) placement to the round window (RW) via the retrofacial approach with preoperative evaluation of the relationship between the facial nerve (FN) and RW by 3D-CT reconstruction was proposed for the treatment of congenital aural atresia (CAA) patient.
A fenestration to the mesotympanum was made mastoid portion of the FN. During the approach, part of the stapedial muscle was encountered and removed. The RW niche was identified, and the floating mass transducer was placed from an inferior approach into the RW niche.
There were no intra-operative or post-operative surgical complications.
The VSB placement to the RW via the retrofacial approach with partial removal of the stapedial muscle can be feasible alternative in CAA cases associated with an anteriorly and laterally positioned aberrant FN. Preoperative assessment using 3D CT may facilitate in assessing the feasibility of the approach and implantation of VSB.
提出一种通过面后入路将振动声桥（VSB）植入圆窗（RW）的方法，术前通过三维CT重建评估面神经（FN）与圆窗的关系，用于治疗先天性耳道闭锁（CAA）患者。
在FN的乳突部制作一个通向中耳鼓室的开窗。在手术过程中，遇到部分镫骨肌并将其切除。识别出圆窗龛，将浮动质量传感器从下方放入圆窗龛。
术中及术后均无手术并发症。
对于伴有向前外侧移位的异常FN的CAA病例，通过面后入路并部分切除镫骨肌将VSB植入圆窗可能是一种可行的替代方法。术前使用三维CT评估可能有助于评估该入路及VSB植入的可行性。
