Goin D W
Laryngoscope. 1982 Mar;92(3):263-72. doi: 10.1288/00005537-198203000-00008.
This paper deals with the surgical approaches to that part of the intratemporal facial nerve lying proximal to the cochleariform process and focuses on two issues: the advisability of disarticulating the ossicular chain to reach this area and the accessibility of the labyrinthine segment via the transmastoid, extralabyrinthine, subtemporal route. Relevant anatomical features, which are based on 39 gross temporal bones, 47 histologic sections, and 10 cadaveric specimens are first considered. In the head specimens, it was possible to attempt exploration of the entire nerve with the transmastoid, extralabyrinthine, subtemporal operation and then remove the labyrinth to gauge the adequacy of this approach as an avenue to the labyrinthine segment. These anatomical findings, their bearing on the questions at hand, and the author's clinical experience are incorporated into descriptions of the operations currently in vogue for exploring the proximal nerve in patients with Bell's palsy.
本文探讨了颞骨内面神经位于匙突近端部分的手术入路，并着重关注两个问题：分离听骨链以到达该区域的可行性，以及通过经乳突、迷路外、颞下途径到达面神经迷路段的可达性。首先考虑基于39块颞骨大体标本、47个组织学切片和10个尸体标本的相关解剖特征。在头部标本中，可以尝试通过经乳突、迷路外、颞下手术来探查整个面神经，然后移除迷路以评估该入路作为到达面神经迷路段途径的充分性。这些解剖学发现、它们与当前问题的关联以及作者的临床经验被纳入了目前用于探查贝尔面瘫患者近端面神经的手术描述中。
