神经导航下内听道及面神经管的解剖研究  

Neuronavigator-assisted study of Anatomy of Internal Auditory Canal and Facial Nerve Canal

作　　者：林爱龙[1] 秦尚振[1] 龚杰[1] 徐国政[1] 马廉亭[1] 李俊[1] 姚国杰[1] 潘力[1] 李爱冰[1] 

机构地区：[1]广州军区武汉总医院神经外科,湖北武汉430070

出　　处：《中国临床神经外科杂志》2006年第1期23-25,共3页Chinese Journal of Clinical Neurosurgery

摘　　要：目的探讨神经导航系统在内听道及面神经管解剖研究中的作用;为经乙状窦后入路手术中安全打开内听道及经岩骨入路手术中保护面神经管提供解剖依据。方法用8具16侧成人汉族尸头标本在神经导航指引下完成经乙状窦后入路手术中到达内听道及经岩骨入路的手术操作,测量导航误差;观测内听道及面神经管的解剖及其与重要结构的关系。结果①所有内听道及面神经管均成功导航,成功率100%,总体误差<0.9mm。②内耳门后下缘到乙状窦后缘中点的距离左侧为(32.15±1.76)mm,右侧为(33.34±1.57)mm;到后半规管后缘中点的距离左侧为(12.51±2.15)mm,右侧为(13.26±2.44)mm。③面神经管岩骨段可划分为三段:前庭段最短,长径(3.6±1.2)mm,管径平均为(1.2±0.3)mm;鼓室段居中,长径(11.2±2.5)mm,平均管径(1.4±0.1)mm;乳突段最长,长径(16.1±3.6)mm,平均管径为(1.7±0.2)mm。结论神经导航辅助对打开内听道及保护面神经管有肯定的价值;熟悉内耳门、面神经管及周围结构的显微解剖有助于手术中保护重要结构。Objectives To explore the effect of neuronavigation system on the anatomy research of internal auditory canal （IAC） and facial nerve canal （FNC）, and to provide the anatomic basis for safely opening IAC during the surgery through retrosigmoid approach and protecting FNC during the surgery through transpetroal approach. Methods Neuronavigator-assisted disection through retrosigmoid and transpetroal approaches was performed in 8 adult cadaver heads to expose IAC and FNC. The fiducial error was determined. The anatomy of the IAC and FNC, and their relationship with the structures around them were observed and measured, Results （1）The mean fiducial error was less than 0.9mm. （2）The distance from the posterior inferior edge of internal ear port to the central point of the posterior edge of the sigmoid sinus was （32.15±1.76）mm on the left, and （33.34±1.57）mm on the right; the distance from the posterior inferior edge of internal ear port to the posterior edge of the posterior semicircular canal was （12.51±2.15）mm on the left, and （13.26±2.44）mm on the right. （3）The FNC was divided into 3 sections, i.e. labyrinthine one （length, 3.6mm 1.2mm; diameter, 1.2mm 0.3mm） tympanic one （length, 11.2mm 2.5mm; diameter, 1.4mm 0.1mm） and mastoid one （length, 16.1mm 3.6mm; diameter, 1.7mm 0.2mm）. Conclusions Neuronavigation system is helpful to opening the IAC and protecting for FNC. The familar microanatomy of the IAC, FNC and related structures is essential to protecting important structures during the microsurgical resection of acoustic neuromas through retrosigmoid and transpetrosal approaches.

关 键 词：神经导航 乙状窦后入路 内听道 经岩骨入路 面神经管 显微外科手术 

分 类 号：R322.81[医药卫生—人体解剖和组织胚胎学] R322.71[医药卫生—基础医学]