面神经移位修复桥小脑角面神经缺损的解剖学研究-耳鼻咽喉科学专业毕业论文.docxVIP

复旦大学硕士毕业论文 复旦大学硕士毕业论文 面神经移位修复桥小脑角面神经缺损的解削学研究 面神经移位修复桥小脑角面神经缺损的解剖学研究 摘要 目的：了解面神经自内听道起至腮腺不同节段移位所获得的节余长度，为 临床修复桥小脑角面神经缺损提供解剖学的依据。 方法：在15具头颅30侧标本上进行3个手术步骤。通过迷路入路面神经 轮廓化l暴露自内听道口至腮腺段面神经。进行以下三次面神经不同节段 的手术移位，分别测量面神经不同移位方法所获得的节余长度。／步骤一、 移位面神经内听道段至距以砧骨短突为标志处最近的面神经部分。步骤 二、移位面神经内听道段至茎乳孔。步骤三、腮腺向后方牵拉移位，面神 经向后移位。完成每个步骤后都将面神经切断重叠放在一起，进行面神经 重叠段的测量。 结果：步骤一、移位面神经内听道段至距以砧骨短突为标志处最近的面神 经部分可获得4 64±l 02mm。步骤二、移位面神经内听道段至茎乳孔可获 得9．5l-t-2 07mm。步骤三、腮腺向后方牵拉移位，面神经向后移位可获 得15 69±2 OOmm。 各项步骤所获得的最大长度分别是：步骤一可获得4 64-1-1．02mm： 在步骤一基础上步骤二可增加的长度是：4 88_+2 49mm；在步骤二基础上 步骤三可增加的氏度是：6 17±1．92mm：使用百分之九十五可信区间分析 每一步骤提示随采用步骤增加可修复神经缺损长度逐渐增加。户 结论：我们的结果表明面神经缺损约15mm的缺损可以通过面神经移位手 术进行修复。 关键词：面神经 神经缺损 神经移位手术 桥小脑角区 壅墨苎；璺堡妻兰塑造塞—— 壅墨苎；璺堡妻兰塑造塞—— 譬整篓整簦璧壅堡尘夔垄垂垫墅蹩蕉黢整篓!妻!!熬 The anatomic study on the repair of the facial nelwe defect in the cerebellopontine angle by facial nerve rerouting Abstract Aim：To quantify the length of the facial nerve defect in cerebellopontine angle that is amenable to a tensionless primary anastomosis with different techniques including rerouting the different portion of facial nerve from inner acoustic cannel to parotid+ Methods：Three surgical procedure were performed on thirty formalin。preserved cadaver hemiheads，The whole facial nerve was recognized and skeletonized in translabyrinthine approach Step 1：Rerouting the facial nerve from the portion of inner acoustic cannel to the portion of facial nerve that is most proximal tO the short process of incus．Step 2：Rerouting the facial nerve from the portion of inner acoustic cannel to the styiomastoid foramen． Step 3：Rerouting the whole facial nerve with retroposition of the parotid gland The facial nelN,e wefe cut in cerebellopontine angle and after performing each procedure described above，the cut facial nerve ends were placed side by side The distance between the overlapped nerve ends were measured with calipers． Results：Our investigation demonstrated that rerouting the facial nerve from the portion of inner acousti