面神经隐窝进路相关解剖测量及临床应用  

Anatomical measurements and clinical applications through facial recess approach

作　　者：王辉兵[1] 单希征[1] 孟昭进[1] 孙悍军[1] 赵龙珠[1] 

机构地区：[1]武警总医院耳鼻咽喉-头颈外科,北京100039

出　　处：《临床耳鼻咽喉头颈外科杂志》2013年第13期708-711,共4页Journal of Clinical Otorhinolaryngology Head And Neck Surgery

基　　金：武警总医院科研课题基金资助(No:WZ2007031)

摘　　要：目的:探讨面神经隐窝进路手术的显微解剖,为临床开展相关手术提供解剖学基础。方法:8例(16侧)成人尸头颞骨按照面神经隐窝进路行手术解剖,观察和测量面神经隐窝进路入口、面神经、镫骨头、圆窗、圆窗龛、锥隆起、匙突等解剖结构,将数据进行统计学处理。结果:面神经隐窝进路骨性入口内外宽度为(2.94±0.32)mm,上下高度为(8.83±0.84)mm,深度为(3.51±0.17)mm。镫骨头与面神经水平段的距离为(1.38±0.21)mm,与面神经乳突段的距离为(6.94±0.47)mm,与圆窗的距离为(3.60±0.55)mm,与匙突的距离为(2.23±0.33)mm,与锤骨前韧带的距离为(4.93±0.61)mm。锥隆起与面神经水平段的距离为(1.05±0.09)mm,与面神经乳突段的距离为(5.63±0.41)mm,与圆窗的距离为(3.01±0.34)mm,与圆窗龛的距离为(3.29±0.44)mm,与匙突的距离为(4.13±0.51)mm。圆窗与匙突的距离为(5.11±0.61)mm,与面神经水平段的距离为(3.97±0.61)mm。圆窗龛与面神经水平段的距离为(4.13±0.38)mm,与面神经乳突段的距离为(7.28±0.29)mm。结论:面神经隐窝进路在现代耳显微外科手术中有重要地位,砧骨短脚、镫骨、锥隆起、匙突的解剖位置比较恒定,可作为术中的参考标志。Objective：To provide the anatomic data for the correlated otologic microsurgery by the microdis- section of temporal bone throug facial recess approach. Method：Sixteen human temporal bones of eight adult cada veric heads were dissected under surgical microscope through facial recess approach, and the relative anatomic structures were observed and measured, such as the bony entrance of facial recess approach, facial nerve, stapes, round window, round window niche, pyramidal eminence, cochleariform process, etc. The data were analyzed statistically. Result：The width of the bony entrance of facial recess approach was（2.94 ± 0.32） ram, the height was（8.83±0.84） mm, the depth was （3.51±0.17） mm. The distances from stapes to tympanic segment of facial nerve, mastoid segment of facial nerve, round window, cochleariform process and anterior ligament of malleus were （1.38±0.21）mm, （6.94±0.47） mm, （3.60±0.55）mm, （2.23±0.33）mm, （4.93±0.61）mm, respec tively. The distances from pyramidal eminence to tympanic segment of facial nerve, mastoid segment of facial nerve, round window, round window niche and cochleariform process were（1. 05±0.09）mm, （5.63±0.41）mm, （3.01±0.34）mm, （3.29±0.44） ram, （4.13±0.51）ram, respectively. The distances from round window to co- chleariform process and tympanic segment of facial nerve were（5.11 ± 0.61） mm and（3.97 ±0.61 ） mm. The dis tances from round window niche to tympanic segment of facial nerve and mastoid segment of facial nerve were （4.13±0.38）mm and（7. 28±0.29）mm. Conclusion：The facial recess approach played an important role in modern otologic microsurgery. The position of anatomical structure was constant relatively, including short crus of incus, stapes, pyramidal eminence and cochleariform process, etc. These could be used as reference marks for otologic microsurgery.

关 键 词：面神经隐窝 中耳 颞骨 解剖学 显微外科手术 

分 类 号：R764.9[医药卫生—耳鼻咽喉科]