神经导航下经乙状窦后入路术中打开内听道及内听道的解剖研究  

Neuronavigation-guided opening of internal auditory canal (IAC) and microsurgical anatomy study of IAC in the retrosigmoid approach

作　　者：林爱龙[1] 秦尚振[1] 徐国政[1] 龚杰[1] 李俊[1] 张振海[1] 姚国杰[1] 潘力[1] 李爱冰[1] 

机构地区：[1]中国人民解放军广州军区武汉总医院神经外科,湖北武汉430070

出　　处：《中国微侵袭神经外科杂志》2004年第6期264-266,共3页Chinese Journal of Minimally Invasive Neurosurgery

基　　金：全军医药卫生科研基金课题(01MA039)

摘　　要：目的探讨基于显微镜的神经导航系统在乙状窦后入路中打开内听道中的作用,为经乙状窦后入路中安全打开内听道提供解剖研究。方法对8具16侧成人汉族尸头标本在神经导航指引下完成乙状窦后入路中到达内听道,观测内听道的解剖及其与重要结构的关系。结果均成功导航,到达内听道的导航平均定位误差是(0.71±0.20)mm,到达后半规管的解剖定位误差是(0.68±0.42)mm。内耳门后下缘到乙状窦后缘中点的距离左侧为(32.15±1.76)mm,右侧为(33.34 ±1.57)mm,内耳门后下缘到后半规管后缘中点的距离左侧为(12.51±2.15)mm,右侧为(13.26±2.44)mm。结论神经导航辅助下打开内听道有肯定的价值;熟悉内耳门及周围结构的显微解剖有助于手术中保护重要结构,Objective To evaluate the usefulness of neuronavigation in opening of IAC in retrosigmoid approach, and to provide anatomic structure of IAC for protecting nerves. Methods A cadaveric study was performed on 16 sides of 8 adult cadaver heads by neuronavigation location via retrosigmoid approach, the anatomy of IAC and the relationship of surrounding structures were observed and measured in mimicking the actual surgical procedure. Results All IAC was successfully navigated. The mean errors of navigation localization were (0.71 ± 0.20) mm for navigation to the IAC and (0.68 ± 0.42) mm for navigation to the posterior semicircular canal. The distance from the posterior inferior edge of internal acoustic port to the central point of the posterior edge of the sigmoid sinus was (32.15 ± 1.76) mm on the left, and (33.34 ± 1.57) mm on the right; the distance from the posterior inferior edge of internal acoustic port to the posterior edge of the posterior semicircular canal was (12.51 ± 2.15) mm on the left, and (13.26 ± 2.44) mm on the right. Conclusion Neuronavigation can be used to assist in opening IAC. Familiarity with the microanatomy of the IAC and surrounding structures is useful to save the function of cranial nerves.

关 键 词：神经导航 乙状窦后入路 内听道 显微外科手术 

分 类 号：R322.923[医药卫生—人体解剖和组织胚胎学]