经乳突面隐窝径路人工耳蜗植入术解剖学研究.docVIP

KKME---专业医学搜索引擎/ 经乳突-面隐窝径路人工耳蜗植入术解剖学研究 　　作者：王明辉,张秋贵,张晓恒,孙彦　　作者单位：天津市第四中心医院耳鼻咽喉科,天津 300143; 青岛大学医学院附属医院耳鼻咽喉科 　　【摘要】目的 通过对人工耳蜗植入手术相关解剖结构进行观察、测量，找出与手术相关因素，为人工耳蜗植入手术提供解剖学依据。方法 取成人颞骨22侧(左右各11侧)，用耳科钻磨开乳突腔，去上鼓室盾板、断桥，磨低骨性外耳道后壁，充分暴露相关结构，在手术显微镜下测量面神经管垂直段起始部前缘至圆窗龛前缘的距离、面神经管最高点与后鼓室底壁之间的距离(后鼓室的深度)、锥隆起的高度(即锥隆起基底到锥隆起顶端的距离)、镫骨头至圆窗龛前缘的距离。结果 面神经管前缘至圆窗龛前缘的距离为 (5.89±0.92)mm(4.75～7.85 mm);后鼓室的深度为(7.02±0.92)mm(4.85～8.79 mm);锥隆起的高度为 (1.90±0.50)mm (0.85～2.73 mm);镫骨头至圆窗龛前缘距离为 (3.00±0.38)mm(2.32～3.71 mm)。结论 砧骨短脚是手术的重要标志;锥隆起解剖位置恒定;后鼓室的深浅对该进路的人工耳蜗植入手术的难易程度有重要影响;前庭窗与圆窗的位置关系相对稳定，因此镫骨头(砧镫关节)可作为参照标志来确定鼓阶钻孔的位置。 　　【关键词】 颞骨;解剖学,局部; 中耳;耳蜗植入术 　　ANATOMY STUDY OF COCHLEAR IMPLANTATION VIA MASTOID-FACIAL RECESS APPROACH　　WANG MING-HUI, ZHANG QIU-GUI, ZHANG XIAO-HENG, et al　　Department of Otolaryngology, No. 4 Central Hospital of Tianjin, Tianjin 300143, China　　[ABSTRACT]ObjectiveTo investigate the correlated parameters of cochlear structure through artificial cochlear implantation in order to provide anatomic data for operation. Methods Twenty-two pieces of temporal bone were taken for this study. The mastoid cavity was opened, scutum removed, bridge broken down, posterior wall of external auditory canal abraded and the related anatomic structures were fully exposed. The distance between the origin of facial nerve canal and the anterior border of round window (OOFNC-ABORW), between the highest point of the facial nerve canal and the bottom of posterior mastoid sinus,and between the stapes head and round window niche (SH-RWN) was measured under operating microscope. ResultsThe distance of OOFNC-ABORW and SH-RWN was 4.75-7.85 (5.89±0.92)mm and 2.32-3.71(3.00±0.38)mm,respectively; the depth of posterior tympanic cavity (PTC) was 4.85-8.79 (7.02±0.92)mm; the height of pyramidal eminence (PE) was 0.85-2.73 (1.90±0.50)mm. Conclusion　The crus breve incudis is an important marker for operation. The anatomical position of PE is constant. The depth of PTC affects the procedure for cochlear implant surge