听骨链重建术的相关解剖测量  

Applied Anatomic Study on Reconstruction of Auditory Ossicular Chain

作　　者：汪昌学[1] 姜苏明[1] 刘金生[1] 李维坚[1] 

机构地区：[1]汕头大学医学院解剖学教研室,广东汕头515041

出　　处：《汕头大学医学院学报》2007年第3期143-145,F0002,共4页Journal of Shantou University Medical College

摘　　要：目的:为听骨链重建术提供听小骨及相关的解剖学资料。方法:取成人完整鼓室标本15例(30侧)凿除乳突和外耳道前、后、下壁,保留上壁,在手术放大镜下测量鼓脐在鼓膜上的位置、锤骨柄至镫骨头距离、锤骨柄直径等。结果:①锤-镫距离最短为(2.38±0.19)cm(2.00～2.70 cm),测量点为锤骨柄末端1/3处外缘和镫骨头;②锤骨柄末段1/3横断面形状接近三角形,弯曲处前、后方向直径为(0.79±0.12)mm,内、外方向直径为(0.58±0.10)mm;锤骨柄与颞线的成角为(83.24±8.33)°(66～98°);③赝复物长轴与镫骨垂直方向成角平均为(27.60±1.75)°(24.6～30.2°);④锤-镫距离与鼓室横径、鼓脐在鼓膜上的位置、锤骨柄直径、锤骨柄的方位的可能相关因素之间相关性检验无统计学意义。结论:①锤骨柄与镫骨头之间的最短距离及锤骨柄的直径对赝复物的设计具有指导意义。②赝复物长轴与镫骨垂直方向成角小于30°,作用于底板传至内耳的力约为原来的0.89倍;横向作用于镫骨的力约为原来的0.46倍。Objective： To provide anatomic data for reconstruction of auditory ossicular chain. Methods： Micranatomical study was carried out on 30 sides of human temporal bones to measure the location of umbo in tympanic membrane, the distance between handle of malleus and stapes head, the diameter of handle of malleus. Results： ①The distance between handle of malleus and stapes head was（2.38 ± 0.19）cm（2.00～2.70 cm）, the point selecting for measuring was outer margin of handle of malleus and stpes head. -②The cross section form of one-third of the handle of malleus at the end, was triangle, the anteroposterior diameter of handle of malleus was（0.79 ± 0.12）mm, the exterior and interior diaraeter was（0.58 ± 0.10）mm at the crook point, the angle of line of manubrium mallei laid（83.24 ± 8.33）°（66～98°） posteroinferior to arch of zygoma. ③The long axis of prosthesis formed（27.60 ± 1.75）°（24.6～30.2°）angle with the perpendieular of stapes. ④The dependablity between the malleus-stapes distance and transverse diameter of tympanum, the location of umbo in tympanic membrane, the diameter of manubrium mallei, angle of line of manubrium mallei and arch of zygoma were not statistically significant. Conclusion： ①The distance between handle of malleus and stapes, the diameter of manubrium mallei are important to the design of prosthesis. ②Long axis of prosthesis form less than a 30-degree angle with the perpendicular of stapes, the strength eontributed to inner ear is about eighty-nine percent of virgin power, the strength contributed to transversal is forty-six percent.

关 键 词：听小骨 听小骨假体 应用解剖 

分 类 号：R322.922[医药卫生—人体解剖和组织胚胎学]