耳内镜下实验解剖内耳门区血管神经  

Experimental anatomical study of identification blood vessels and nerves in internal acoustic pore

作　　者：王少植[1] 夏寅[1] 周兵[1] 王政伟[2] 贺飞[1,3] 韩德民[1,3] 

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,耳鼻咽喉头颈科学教育部重点实验室(首都医科大学) [2]北京军区总医院神经外科 [3]北京市耳鼻咽喉科研究所,北京100005

出　　处：《中国耳鼻咽喉头颈外科》2008年第3期131-133,共3页Chinese Archives of Otolaryngology-Head and Neck Surgery

基　　金：北京市自然科学基金课题(7212008;7031001)及首都医学发展科研基金项目(2003-1013)联合资助

摘　　要：目的利用不同角度耳内镜对内耳门区的血管、神经进行解剖观测,为临床开展桥脑小脑角区微创外科手术提供解剖学依据。方法10%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,分别以0°、30°、70°耳内镜对内耳门区的血管、神经进行解剖观测、分析。结果①内耳门区动脉袢出现率为70%(21/30),而且大部分需借助30°或70°内镜方能明确;②前庭耳蜗神经裂隙界面在内耳门区出现率为60%(18/30),其中12侧此裂隙界面位于内耳道外、Ⅷ脑神经束的外表面,用0°内镜即可直接看到;另外6侧此裂隙界面位于内耳道内、Ⅷ脑神经束的下表面,只有用30°或70°的内镜才能看到,与Ⅷ脑神经束进入内耳道前所形成之前庭耳蜗神经裂隙界面恰成90°旋转。结论应用多角度耳内镜才能清晰观察并确认内耳门区的动脉袢及定位前庭耳蜗神经裂隙界面。OBJECTIVE To provided related information on posterior cranial fossa minimally invasive surgery aided by endoscope with retrolabyrinthine approach from observation with different angle endoscopes. METHODS Fifteen adult cadaver heads （30 sides） fixed with formalin were used in the study. Retrolabyrinthine approach operations were imitated for endoscope application in cerebellopontine angle and internal acoustic pore and the blood vessels and nerves in that area were observed with 0° , 30° and 70° endoscope respectively. RESULTS （1）The incidence of vascular loops in internal acoustic pore was 70 % （21/30） , most of them can only be seen with 30° or 70° endoscope. （2）The incidence of cochlea-vestibule nerve cleavage plane in internal acoustics pores and cerebellopontine angle was 60 % （18/30） , 2/3 of which were in cerebellopontine angle on the surface of Ⅷ cranial nerve, it can be seen with 00 endoscope directly. The another 1/3 were in internal acoustic canal which can been seen only with 30° or 70° endoscope, and those were below the surface of Ⅷ cranial nerves. CONCLUSION In most cases, the arterial loops and cochlea-vestibule nerves cleavage plane that enter internal acoustic canal only can be identified with different angle endoscope.

关 键 词：小脑脑桥角 内窥镜检查 尸体解剖 

分 类 号：R764[医药卫生—耳鼻咽喉科] R322[医药卫生—临床医学]