Spector J G, Ge X
Department of Otolaryngology-Head and Neck Surgery, Washington University School of Medicine, St. Louis, Mo.
Laryngoscope. 1993 Sep;103(9):1052-65. doi: 10.1288/00005537-199309000-00018.
Dehiscences in the bony facial canal are comparatively common in the human adult. The highest incidence occurs in the tympanic segment of the facial nerve near the region of the oval window. Thirty-three fetal temporal bones, ranging from 16 to 40 weeks' gestation, and four from 1, 2, 4 and 12 weeks' postpartum neonates, were studied to evaluate the normal patterns of ossification of the fallopian canal of the tympanic facial nerve segment in the human. The tympanic facial nerve segment elongates three-fold during this period (from 1 mm to 3 mm). The ossification starts at 21 weeks' gestation anteriorly from apical otic ossification centers and at 26 weeks from canalicular ossification centers near the stapedius muscle. The ossification proceeds in an anterior-to-posterior direction as two periosteal shelves of bone surround the facial nerve. The superior periosteal bony ledge contributes 75% of the circumference of the fallopian canal. The anterior ossification center forms over 83% of the fallopian canal length. The two centers fuse post partum near the region of the oval window. The anatomic location of the facial nerve, nerve branching, and neural vasculature precede ossification. In 80% of the paired temporal bones, this ossification pattern appears to be symmetrical. The patterns and incidence of bony dehiscences within the tympanic fallopian canal segment can be explained by these observations. This study demonstrates that fallopian canal dehiscences are not congenital anomalies, but variations of normal developmental anatomic processes.
在成年人体内,面神经骨管裂相对常见。最高发生率出现在面神经鼓室段靠近卵圆窗区域。研究了33例妊娠16至40周的胎儿颞骨以及4例出生后1周、2周、4周和12周新生儿的颞骨,以评估人类鼓室面神经段面神经管的正常骨化模式。在此期间,鼓室面神经段长度增加两倍(从1毫米增至3毫米)。骨化始于妊娠21周,从耳尖骨化中心向前开始,26周时从镫骨肌附近的小管骨化中心开始。骨化沿前后方向进行,两块骨膜骨板围绕面神经。上方的骨膜骨嵴占面神经管周长的75%。前方骨化中心形成超过83%的面神经管长度。产后,两个中心在卵圆窗区域附近融合。面神经的解剖位置、神经分支和神经血管系统在骨化之前就已存在。在80%的双侧颞骨中,这种骨化模式似乎是对称的。鼓室面神经管段内骨管裂的模式和发生率可以通过这些观察结果来解释。本研究表明,面神经管裂不是先天性异常,而是正常发育解剖过程的变异。