经耳内镜鼓窦与上鼓室入路人工耳蜗植入的解剖研究  

Anatomic study of cochlear implantation via tympanic antrum and epitympanum under ear endoscope

作　　者：张新海[1] 尹兴红[1] 李科 李可亮 闫智强 ZHANG Xinhai;YING Xinghong;LI Ke;LI Keliang;YAN Zhiqiang(Department of Otolaryngology Head and Neck Surgery,Fuyang People's Hospital,Fuyang,Anhui,236600,China)

机构地区：[1]阜阳市人民医院耳鼻咽喉头颈外科,安徽阜阳236600

出　　处：《中国耳鼻咽喉头颈外科》2021年第2期76-78,共3页Chinese Archives of Otolaryngology-Head and Neck Surgery

摘　　要：目的探讨经耳内镜鼓窦、上鼓室自然通道人工耳蜗植入术的可能性。方法在4例冰冻成人正常颞骨标本开展新手术入路,并测量相关参数,术后中耳高分辨CT加以证实。结果所有标本均切开鼓窦,经鼓窦入口、上鼓室、中鼓室放置植入电极,在耳内镜下经外耳道鼓室切开显露蜗窗龛,通过蜗窗植入电极,未损伤鼓索神经、面神经。鼓后峡宽度(4.65±0.19)mm,鼓窦、上鼓室、中鼓室自然通道长度(20.67±0.96)mm,蜗窗外侧缘距鼓索神经出骨性鼓环处距离(4.89±0.35)mm。结论耳内镜下经鼓窦、上鼓室、中鼓室径路人工耳蜗植入术是一种微创、安全的手术方式,对乙状窦前移、脑膜低垂、面神经隐窝狭窄病例更具有其优势,并且对于其存在的局限性和并发症风险等问题需进一步研究。OBJECTIVE To explore a new approach for cochlear implantation via natural channels of the tympanic antrum,epitympanum,and mesotympanum under an ear endoscope.METHODS A new surgical approach was carried out in 4 frozen adult normal temporal bone specimens,and the relevant parameters were measured.RESULTS All specimens were incised into the tympanic antrum and electrodes were placed through the entrance of the tympanic antrum,epitympanum,and mesotympanum.The width of the drum posterior isthmus was(4.65±0.19)mm.The natural passage length of the tympanic antrum,and upper and middle tympanum was(20.67±0.96)mm.The distance between the lateral margin of the circumferential window and eminence of the chorda tympani nerve was(4.89±0.35)mm.CONCLUSION Endoscopic cochlear implantation via natural channels of the tympanic antrum,epitympanum,and mesotympanum is a minimally invasive,safe,and feasible method that has advantages in patients with the following findings:sigmoid sinus moves forward;meningeal drooping;and narrow facial nerve fossae.The limitations and risk of complications warrant further study.

关 键 词：耳蜗植入物 内窥镜检查 耳内镜 鼓窦 上鼓室 

分 类 号：R764.9[医药卫生—耳鼻咽喉科]