人工耳蜗植入经颅中窝入路的相关解剖  

Anatomic study of cochlear implantation via the middle fossa

作　　者：汪昌学[1] 姜苏明[1] 刘锦峰[2] 李维坚[1] 涂良携[1] 

机构地区：[1]汕头大学医学院解剖教研室,广东汕头515041 [2]首都医科大学附属朝阳医院耳鼻咽喉头颈外科,北京100020

出　　处：《中国临床解剖学杂志》2008年第4期369-372,共4页Chinese Journal of Clinical Anatomy

摘　　要：目的:为经颅中窝进行耳蜗植入术提供解剖资料,同时寻找定位植入点的方法。方法:取成人头颅标本15例(30侧),开颅后在颞骨岩部磨出蜗螺旋管底圈鼓阶最高点和相关结构,观测其与周围重要解剖结构的关系。结果:①颅中窝入路鼓阶植入点位于岩嵴下方,两者间骨质厚度为(8.58±2.28)mm;在内耳道前方,距内耳道底距离为(1.47±0.30)mm;在岩大神经后方,距其距离为(3.88±0.52)mm;在面神经内侧,距其距离为(2.80±0.26)mm;在前半规管内侧,距其距离为(9.46±1.01)mm;②植入点至蜗窗上缘的鼓阶长度为(12.03±1.26)mm;③颈内动脉的膝部位于耳蜗的内下方,与蜗螺旋管底圈间骨质厚度为(1.54±0.47)mm;耳蜗最高点与颈内动脉膝部埋藏深度相差(6.67±2.07)mm。结论:①岩大神经是手术时重要的定位标志,面神经是手术中需要保护的重要解剖结构。Objective： To provide anatomic data for cochlear implantation via the middle fossa, and explore the method of locating the cochleostomy site （CS）. Methods： The study was carried out on 30 sides of human temporal bones with observing and measuring the depth fi＇om the crista petrosa to the superior portion of the basal turn （SPBT） and the distances from the facial, greater petrosal nerves and the round window. Results： （1） The depth from the crista petrosa to SPBT of the cochlea was （8.58±2.28）mm. Distances from the cochleostomy site to the fundus of internal acoustic meatus （IAM）, to the greater petrosal nerve（GSPN）, to the labyrinthine portion of the facial nerve （FN）, and to the anterior semicircular canal （ASC） was （1.47±0.30）mm, （3.88 ±0.52）mm, （2.80 ±0.26）mm and （9.46±1.01）mm respectively. （2） The length of scala tympani from the cochleostomy site to the round window was （12.03±1.26）mm. （3）The bend portion of internal carotid artery （ICA） located medially and inferiorly of the basal turn of cochlea. The bony interval between the cochlea and the petrous ICA canal was （1.54±0.47）mm, and the depth from SPBT to the ICA was （6.67±2.07）mm. Conclusions： Greater petrosal nerve is the landmark of cochleostomy, the labyrinthine portion of the facial nerve was the important anatomic structure need to be protected.

关 键 词：耳蜗植入术 颅中窝入路 面神经 岩大神经 

分 类 号：P323.1[天文地球—地球物理学]