迷路后进路内镜手术中内耳道的定位  

Anatomical study of identification internal acoustic canal in posterior cranial fossa endoscopes surgery

作　　者：王少植[1] 夏寅[1] 周兵[1] 韩德民[1] 王政伟[2] 贺飞 

机构地区：[1]首都医科大学附属北京同仁医院耳鼻咽喉-头颈外科,北京100730 [2]北京军区总医院神经外科 [3]北京耳鼻咽喉研究所

出　　处：《临床耳鼻咽喉头颈外科杂志》2007年第13期593-595,共3页Journal of Clinical Otorhinolaryngology Head And Neck Surgery

基　　金：北京市自然科学基金课题(No:7212008;7031001);首都医学发展科研基金项目(No:2003-1013)

摘　　要：目的:为迷路后进路处理桥脑小脑角区及内耳门区病变手术中内耳道的定位提供参考依据。方法:4%多聚甲醛固定的成人头颅标本(正常完整颅底)15例(30侧,性别不限),模拟迷路后进路操作,沿外半规管平面导入0°2.7 mm耳内镜,观察内耳道与外半规管的关系。结果:内耳道口中心与外半规管平面一致,面听神经束的走行(内耳道走行)与外半规管平面的关系:①面听神经起始部位于外半规管平面之下者2侧(6.7%);②面听神经起始部位于外半规管平面者15侧(50.0%);③面听神经起始部位于外半规管平面之上者13侧(43.3%)。结论:在迷路后进路桥脑小脑角区及内耳道手术中,以外半规管定位内耳道具有直接、准确、对周围组织损伤小的优点,更符合微创外科手术的要求。Objective：To provide a new method to anatomically study the cerebellopontine angle （CPA） and internal acoustic canal in endoscopic surgery with retrolabyrinthine approach. Method：Fifteen adult cadaver heads （30 sides） fixed with formalin were used in the study. After mastoid sketelization, a 0° 2. 7 mm endoscope was placed to cerebellopontine angle and internal acoustic pore along the lateral semicircular plane to observe the relationship between Ⅶ, Ⅷ cranial nerve and lateral semicircular. Result：The internal acoustic pore was just at the plane of lateral semicircular. There were 13, 15 and 2 of 30 specimens whose origination of Ⅶ, Ⅷ cranial nerves above, parallel to and below to the plane of lateral semicircular canal respectively. Conclusion： Using the lateral semicircular canal as a landmark to directly, exactly identify the internal acoustic canal in cerebellopontine angle and internal acoustic canal surgery with retrolabyrinthine approach could minimize the damage of normal structure, which met the concept of minimally invasive surgery.

关 键 词：解剖学 局部 内镜 内耳道 

分 类 号：R764.93[医药卫生—耳鼻咽喉科]