颅中窝入路听神经瘤手术相关解剖标志的三维成像研究  

Three dimensional computed tomographic study of anatomical landmarks related to surgery of auditory neuroma via middle fossa approach

作　　者：郭翠翠[1] 夏寅[1] 常青林[2] 尹红霞[2] 龙海珊[1] 

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]首都医科大学附属北京同仁医院医学影像科,北京100730

出　　处：《中国耳鼻咽喉颅底外科杂志》2009年第5期321-325,共5页Chinese Journal of Otorhinolaryngology-skull Base Surgery

基　　金：北京市优秀人才培养资助(A类;编号:20061A0300300070)

摘　　要：目的利用多层螺旋CT扫描三维成像(3 D-CT)技术研究颅中窝入路听神经瘤手术时上半规管与弓状隆起之间的相互解剖关系,评价3 D-CT对颅中窝听神经瘤手术方式选择的有效性。方法选取1 4例干颅和7例1 0%甲醛固定的成人头颅标本进行颞骨部位的多层螺旋CT扫描,利用AW4.1工作站对上半规管和弓状隆起解剖关系进行测量。结果3 D-CT可以清晰显示颅中窝及岩骨重要的解剖标志,上半规管和弓状隆起二者间的空间关系并非完全一致。结论弓状隆起并非是判断上半规管最精确的标志点,术前通过3 D-CT可以清晰显示上半规管与弓状隆起二者的空间位置关系,以指导术中避免损伤上半规管及准确定位内听道,通过术前3 D-CT可以达到个体化治疗的目的。Objective To study the three-dimensional（3D） relationship between the arcuate eminence（AE） and superior semicircular canal（SSC） using three-dimensional computed tomography（3D-CT） and to evaluate the utility of 3D-CT for preoperative planning for surgical approaches to the middle cranial fossa.Methods The anatomical relationship between the AE and the SSC was studied by computed tomography in 14 dry temporal bones and 7 cadaveric temporal bones.The distance between the AE and the SSC,the angle between the AE and the SSC,the distance and the angle between the SSC and the superior surface of the petrous bone were measured with AW4.1 workstation.Results 3D-CT clearly demonstrated the relationships among traditional landmarks along the petrous ridge and the middle cranial fossa.The relationship between the AE and SSC was found to be highly variable.Conclusion There are significant variabilities in the relationship between the AE and the SSC.The AE is not a consistent or reliable landmark for identifying the precise position of the SSC.Detailed preoperative information regarding the relationship between the AE,SSC,and other bony landmarks can be easily and quickly assessed using 3D-CT.

关 键 词：手术入路 颅中窝 弓状隆起 上半规管 CT扫描三维成像 听神经瘤 

分 类 号：R323.1[医药卫生—人体解剖和组织胚胎学] R739.61[医药卫生—基础医学]