Gaziantep University, Faculty of Medicine, Department of Anatomy, Gaziantep, Turkey.
Mersin University Faculty of Medicine, Department of Otorhinolaryngology, Mersin, Turkey.
J Int Adv Otol. 2023 Jan;19(1):45-49. doi: 10.5152/iao.2023.22682.
The aim of the study was to measure the distance of the tympanic nerve to the oval window and round window niche in adult cadavers for evaluating its usability as an anatomical landmark during middle ear-related surgeries, including stapedotomy and cochleostomy, and for preventing its iatrogenic damage during surgical practices such as otosclerosis surgery and cochlear implantation.
The middle ears of 10 adult cadavers aged 74.70 ± 14.56 years were bilaterally dissected with the help of an endoscope and microscope to measure the distance of tympanic nerve to round window niche and oval window.
Tympanic nerve was found as 1.60 ± 0.86 mm (range, 0-3.11 mm) and 1.55 ± 0.38 mm (range, 1.04-2.20 mm) away from round window niche and oval window, respectively. In relation to the quantitative values of these 2 distances, neither right-left nor male-female significant differences were determined (P > .05). Tympanic nerve was observed in all temporal bones. In terms of the shape and twigs of tympanic nerve, extreme variations among cadaveric temporal bones were determined. Tympanic nerve-round window niche distance between 0-1 mm was defined as type 1 (20%), between 1 and 2 mm as type 2 (45%), between 2 and 3 mm as type 3 (30%), and between 3 and 4 mm as type 4 (5%).
Tympanic nerve may be vulnerable at round window niche- or oval window-related surgeries (e.g., cochleostomy).
本研究旨在测量成人尸检中鼓索神经到卵圆窗和圆窗龛的距离,以评估其在中耳相关手术(包括镫骨切开术和耳蜗切开术)中作为解剖标志的可用性,并防止其在耳硬化症手术和耳蜗植入等手术实践中受到医源性损伤。
借助内窥镜和显微镜对 10 具年龄在 74.70±14.56 岁的成人尸检的双侧中耳进行解剖,以测量鼓索神经到圆窗龛和卵圆窗的距离。
鼓索神经距圆窗龛和卵圆窗分别为 1.60±0.86mm(范围 0-3.11mm)和 1.55±0.38mm(范围 1.04-2.20mm)。就这两个距离的定量值而言,左右侧和男女之间均无显著差异(P>0.05)。在所有颞骨中均观察到鼓索神经。就鼓索神经的形状和分支而言,在不同的尸检颞骨之间存在极端的变异。将鼓索神经-圆窗龛距离定义为 0-1mm 为 1 型(20%),1-2mm 为 2 型(45%),2-3mm 为 3 型(30%),3-4mm 为 4 型(5%)。
鼓索神经在圆窗龛或卵圆窗相关手术(例如耳蜗切开术)时可能容易受损。