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耳蜗-颈动脉间隙:人体颞骨尸体标本的手术见解与影像学发现的桥梁

Cochlear-Carotid Interval: Bridging Surgical Insights and Radiological Findings in Cadaveric Human Temporal Bones.

作者信息

Lakhawat Rajendra Singh, Kataria Tanmaya, Grover Mohnish, KishorLohar Nand, Badlani Dinesh Kumar

机构信息

Department of Otorhinolaryngology, RVRS Medical College and Attached Mahatma Gandhi Hospital, Bhilwara, Rajasthan, India.

Department of Otorhinolaryngology, Mahatma Gandhi Medical College, Jaipur, Rajasthan, 302033 India.

出版信息

Indian J Otolaryngol Head Neck Surg. 2024 Oct;76(5):4265-4269. doi: 10.1007/s12070-024-04832-3. Epub 2024 Jun 29.

Abstract

The temporal bone is a complex neurovascular structure. The procedure of cochlear implantation is performed with in few millimetres of area around which important structures like internal carotid artery, jugular bulb and facial nerve are present. Displacement of an electrode into the carotid canal although rare is considered as a major complication in cochlear implant surgery. The purpose of this study is to highlight the close anatomic relationship (radiologically as well as on cadaveric temporal bone dissection) between the cochlea and the carotid canal and its variations which will be helpful during cochlear implant (CI) surgery to prevent injury to internal carotid artery. This study was done in SMS Medical College and Hospital, Jaipur, India. High resolution computed tomography (HRCT) of cadaveric temporal bones was done after getting permission from ethical committee of the institute. 40 bones were studied. Cochlear carotid interval (CCI) was measured with the help of dicom reader and the same temporal bones were dissected under microscope and CCI was measured with help of millimetre scale. The CCI was found to be 2.08 ± 0.89 mm and it was ranging from 0.48 to 4.25 mm on HRCT temporal bone and on dissection 2.19 ± 0.85 mm and it was ranging from 0.85 to 4.12 mm. With the increasing popularity of CI surgeries, the importance of the CCI has become more pronounced, highlighting the need for meticulous surgical planning and technique. To the best of our knowledge this is the first study of CCI which is correlating radiological and dissection anatomy of CCI.

摘要

颞骨是一个复杂的神经血管结构。人工耳蜗植入手术是在几毫米的区域内进行的,该区域周围存在颈内动脉、颈静脉球和面神经等重要结构。电极移位至颈动脉管虽然罕见,但在人工耳蜗植入手术中被视为主要并发症。本研究的目的是强调耳蜗与颈动脉管之间紧密的解剖关系(在放射学以及尸体颞骨解剖方面)及其变异情况,这将有助于人工耳蜗植入(CI)手术中预防颈内动脉损伤。本研究在印度斋浦尔的SMS医学院及医院进行。在获得该机构伦理委员会许可后,对尸体颞骨进行了高分辨率计算机断层扫描(HRCT)。共研究了40块颞骨。借助DICOM阅读器测量耳蜗颈动脉间距(CCI),并在显微镜下对相同的颞骨进行解剖,借助毫米尺测量CCI。HRCT颞骨上测得的CCI为2.08±0.89毫米,范围在0.48至4.25毫米之间,解剖时测得为2.19±0.85毫米,范围在0.85至4.12毫米之间。随着CI手术越来越普及,CCI的重要性愈发凸显,这突出了精心手术规划和技术的必要性。据我们所知,这是第一项将CCI的放射学和解剖学相关联的研究。

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本文引用的文献

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Cochlear implant electrode misplaced in the carotid canal.
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