Gopen Q, Rosowski J J, Merchant S N
Department of Otolaryngology, Massachusetts Eye and Ear Infirmary, Boston 02114, USA.
Hear Res. 1997 May;107(1-2):9-22. doi: 10.1016/s0378-5955(97)00017-8.
There is great variation in published descriptions of the shape, size, and patency of the human cochlear aqueduct. The first part of this paper describes the anatomy of the normal human cochlear aqueduct as determined from a study of 101 temporal bones. Nineteen bones aged 0-1 years and approximately 10 bones per decade of life until age 100 years were examined. The aqueduct was found to have a funnel shaped aperture at the cranial end with a dural sheath extending into it for a varying distance. The rest of the aqueduct was filled with a meshwork of loose connective tissue, often with a central lumen within it. Four types of patencies were noted: central lumen patent throughout length of aqueduct (34%), lumen filled with loose connective tissue (59%), lumen occluded by bone (4%), and obliteration of the aqueduct (3%). The mean value (+/- SD) of the narrowest portion was 138 (+/- 58) microns which occurred 200-300 microns from the cochlear end of the aqueduct. There was no correlation between age and narrowest diameter, or between age and category of patency. In the second part of this paper, we propose quantitative models of aqueduct function, based on measurements of ductal dimensions and known acoustical properties of the inner ear. Our model analyses suggest that in normal ears, the aqueduct (1) cannot support fluid flows large enough to explain stapedectomy gushers, (2) does filter out cardiac- and respiration-induced pulses in CSF and prevents them from affecting cochlear function, and (3) has little effect on normal ossicular transmission of sound for frequencies above 20 Hz. In pathological ears, such as those with ossicular disruption or after a type IV tympanoplasty, a patent aqueduct might affect hearing for frequencies below 150 Hz.
关于人类蜗水管的形状、大小及通畅情况，已发表的描述存在很大差异。本文第一部分描述了正常人类蜗水管的解剖结构，该研究基于对101块颞骨的研究。检查了19块0至1岁的骨头，以及每十年约10块直至100岁的骨头。发现蜗水管在颅端有一个漏斗状开口，有一层硬膜鞘延伸到其中一段可变的距离。蜗水管的其余部分充满了疏松结缔组织网，内部通常有一个中央管腔。记录到四种通畅类型：中央管腔在蜗水管全长均通畅（34%）、管腔充满疏松结缔组织（59%）、管腔被骨阻塞（4%）以及蜗水管闭塞（3%）。最窄部分的平均值（±标准差）为138（±58）微米，位于距蜗水管蜗端200至300微米处。年龄与最窄直径之间，或年龄与通畅类别之间均无相关性。在本文的第二部分，我们基于蜗水管尺寸测量和内耳已知声学特性，提出了蜗水管功能的定量模型。我们的模型分析表明，在正常耳中，蜗水管（1）无法支持足以解释镫骨切除术后涌流现象的大流量液体流动，（2）确实能滤除脑脊液中由心脏和呼吸引起的脉冲，并防止它们影响耳蜗功能，并且（3）对频率高于20Hz的正常听骨链声音传导影响很小。在病理状态的耳中，如那些听骨链中断或IV型鼓室成形术后的耳朵，通畅的蜗水管可能会影响150Hz以下频率的听力。
