听神经瘤手术涉及的面神经段显微解剖及临床意义  

Microsurgical anatomy and clinical significance of facial nerve in relation to acoustic neuromas

作　　者：王社军[1] 于春江 杜长生[1] 张波[3] 唐红[1] 闫长祥 杨军 王任直[3] 

机构地区：[1]中国人民武装警察部队总医院神经外科,北京100039 [2]三博复兴脑科医院神经外科,北京100038 [3]中国医学科学院北京协和医院神经外科,北京100730

出　　处：《中国微侵袭神经外科杂志》2005年第7期317-319,共3页Chinese Journal of Minimally Invasive Neurosurgery

摘　　要：目的探讨听神经瘤涉及的面神经段显微解剖,为听神经瘤手术提供解剖学数据。方法采用10%甲醛溶液充分固定的成人尸头标本15例,对面神经的脑干端、桥小脑角段、内耳道段及其毗邻结构进行测量和拍摄。结果面神经脑干端与周围解剖结构有恒定距离;桥小脑角段由面神经运动根、中间神经组成,与前庭蜗神经走行关系恒定;内耳道段面神经运动根在位听神经前上方,中间神经和面神经运动根在内耳道中部合成一干,面神经在内耳道底的横嵴上垂直嵴前走行;迷路段是面神经在颞骨内最短、最细的部分。结论研究听神经瘤涉及的面神经段显微解剖,有助于听神经瘤的切除,保护面神经。Objective To study the microsurgical anatomy of the facial nerve involved in acoustic neuromas in order to provide anatomic data for the operation of acoustic neuromas. Methods On 15 adult cadaver heads fixed in formalin, microanatomy of the brain stem, cerebellopontine angle, internal acoustic meatus (IAM) and labyrinthine segment of the facial nerve and the related structures were observed and measured. Results There is a stable distance between brain stem segment of facial nerve and related anatomical structures, cerebellopontine angle segment is composed of motor root of the facial nerve and intermediate nerves, which have stable relation with vestibulocochlear nerve; In IAM, motor root of the facial nerve located above acoustic nerve, intermediate nerve and motor root of the facial nerve become one stem in the middle of IAM. Near the bottom of IAM, facial nerve is on the transverse crest in IAM, go in front of Bill bar; labyrinthine segment of the facial nerve is the finest and shortest part in temporal bone. Conclusion Studying microanatomy of the facial nerve involved in acoustic neuromas is fundamental in resecting acoustic neuromas and preserving the facial nerve.

关 键 词：神经瘤 听 面神经 显微外科手术 神经解剖 

分 类 号：R739.4[医药卫生—肿瘤]