经乳突颞下迷路外径路面神经显微手术的解剖研究  

The anatomy of facial nerve decompression through transmastoid,extralabyrinthine,subtemporal approach

作　　者：周慧芳[1] 梁政[1] 王长月[2] 王建[2] 

机构地区：[1]天津医科大学总医院耳鼻喉科,天津300052 [2]天津医科大学解剖教研室

出　　处：《天津医科大学学报》2005年第2期216-219,共4页Journal of Tianjin Medical University

摘　　要：目的:验证经乳突颞下迷路外径路面神经手术的可行性和安全性,测量此径路手术所需的解剖数据。方法:手术显微镜下对成人颞骨标本20侧,成人尸头20侧模拟手术径路操作,测量面神经解剖及其与重要结构的关系。结果:成人颞骨干标本的各项结果:匙突至膝状神经节窝面神经交角处距离(3.80±0.72)mm;面神经水平段长(11.14±0.73)mm;迷路段长(3.35±0.68)mm;耳蜗底转至迷路段距离(1.04±0.14)mm;迷路段的天盖厚度(2.82±0.64)mm;水平段至外半规管隆突距离(1.27±0.21)mm;水平段至前半规管壶腹中点距离(2.47±0.42)mm。尸头的各项结果:砧骨长脚至水平段垂直距离(2.33±0.26)mm;砧骨短脚尖端到面神经垂直距离(3.06±1.01)mm;锤骨头至水平段距离(2.17±0.40)mm;锤骨头至鼓室天盖距离(2.31±0.87)mm;垂直段长(16.27±0.58)mm;膝状神经节的近端和远端的夹角(74.3±2.47)°;锥曲的角度(110.2±8.30)°。结论:本研究提供了经乳颞下迷路外径路面神经减压术所需安全范围、操作空间、角度等,可供手术时参考。Objective To validate the feasibility and security of the facial nerve decompression through transmastoid extralabyrinthine subtemporal approach To get the data about this approach. Methods Under the operation microscope 20 adult temporal bones and 20 sides of cadaveric skulls were dissected through transmastoid extralabyrinthine subtemporal approach . Various distances of facial nerve and key mark were measured. Results 20 adult temporal bonesSD 1 the distance between choleariform process and the angle point of proximal end to distal end in geniculate ganglion was3.80±0.72 mm. 2 the length of horizontal segment was 11.14±0.73 mm.3 the length of labyrinthine segment was 3.35±0.68 mm. 4 the distance between basal turn of the cochlea and the labyrinthine segment was 1.04±0.14 mm. 5 the tegmen thickness in most distal point of labyrinthine segment was 2.82±0.64 mm. 6the shortest distance between facial canal in horizontal segment and the lateral semicircular canal was 1.27±0.21 mm.7the distance between facial canal in horizontal segment and middle point of anterior semicircular canal ampulla was 2.47±0.21 mm. 20 sides of cadaveric skullsSD 1the distance between long process of incus and horizontal segment was 2.33±0.26 mm. 2 the distance between short process of incus and facial nerve was 3.06±1.01 mm. 3 the distance between capitulum of malleus and the horizontal segment was 2.17±0.87 mm. 4 the distance between capitulum of malleus and tegmen tympani was 2.31±0.87 mm. 5 the length of vertical segment was 16.27±0.58mm. 6the angle of proximal end to distal end in geniculate ganglion was 74.3±2.47°. 7 7the angle of pyramidal segment was 110.2±8.30°. Conclusion This study provided the safe scope manipulation room and the angle of the transmastoid extralabyrinthine subtemporal approach and these

关 键 词：面神经 面神经手术 颞骨解剖 周围性面瘫 

分 类 号：R764.3[医药卫生—耳鼻咽喉科]