乙状窦前迷路后入路中后骨半规管定位与保护的应用解剖  

Applied Anatomy for localization and preservation of post semicircular canal during presigmoid-retrolabyrinthine approach

作　　者：王君玉[1] 廖建春[2] 党瑞山[3] 施小恬[1] 刘环海[2] 胡国汉[2] 张晖[2] 姚琪[1] 

机构地区：[1]太仓市中医院耳鼻喉科,太仓215400 [2]第二军医大学长征医院耳鼻喉-头颈外科,上海200003 [3]第二军医大学解剖学教研室,上海200433

出　　处：《解剖学杂志》2007年第2期221-223,共3页Chinese Journal of Anatomy

基　　金：第二军医大学长征医院联合攻关课题(2004002)

摘　　要：目的:为乙状窦前入路中安全磨出半规管提供解剖学资料。方法:经10%福尔马林溶液固定的成人尸头标本15个共30侧。磨除Trautman三角的骨质,暴露乙状窦、岩上窦、岩上窦-乙状窦交点、上骨半规管及面神经垂直段、颈静脉球,测量后骨半规管与毗邻结构的距离。结果:后骨半规管与硬化型的乳突对后骨半规管的安全磨出影响较大。鼓室窦存在率100%。后骨半规管的定位:骨质的改变;乙状窦前含乳突小房的松质骨中出现致密的象牙骨质提示接近后骨半规管;颅后窝硬膜皱褶自乙状窦向深层汇集点,提示接近后骨半规管;鼓室窦暴露后,通过外骨半规管定位后骨半规管。结论:鼓室窦可以定位外骨半规管,继而定位后骨半规管;明确毗邻的结构关系可以为安全磨出后骨半规管提供保证。Objective： To provide anatomic data for safely drilling out the post semicircular canal during the presigmoid approach. Methods： Correlative data from 15 adult cadaveric specimens were measured. The bone in Trautman＇s angle was drilled out, and the sigmoid sinus, superior petrosal sinus, petrosigmoid intersection, bony semicircular canals, vertical part of the facial nerve and jugular bulb were exposed. The distance between the post semicircular canal and its neighborhood structures was recorded. Results： The mastoid affected drilling out the posterior semicircular canals safely. The occurrence rate of the sinus tympani was 100%. The lateral semicircular canal was located in the sinus tympani. The posterior semicircular canal could be found through the change of the bone density, appearance of the dura mater reductus and exposure of the lateral semicircular canal. Conclusion.. The post semicircular canal can be found through correct exposure of the sinus tympani. Knowing the anatomic structure relationship may provide a method for the localization of the post semicircular canal.

关 键 词：后骨半规管 乙状窦前入路 鼓室窦 应用解剖 

分 类 号：R322[医药卫生—人体解剖和组织胚胎学] R651.1[医药卫生—基础医学]