颞骨手术相关的面神经临床解剖学研究

目的探讨颞骨手术中面神经的解剖学特点及手术中的定位方法。方法 (1)在15例尸头标本上(30侧)模拟完壁式乳突根治术,面神经隐窝入路,面神经减压手术,迷路下入路,颅中窝入路内耳道等手术,观察面神经形态及其与周围结构的关系;(2)30例干颞骨标本采用断面方法观察面神经管与周围主要结构之间的关系。结果 (1)面神经垂直段中点距离乙状窦前壁(6.42±2.65)mm,距离颈静脉球外侧壁(3.58±1.33)mm。(2)面神经隐窝外侧气房明显存在者86.67%(26例),不明显者13.33%(4侧),面神经隐窝外侧气房可以定位面神经与面神经隐窝。(3)在外半规管中后1/3交点下方(1.70±0.33)mm可定位面神经锥段,向下与二腹肌嵴前端连线是面神经垂直段位置。(4)膝神经节位于匙突前(2.48±0.23)mm。(5)弓状隆起外侧端前方是内耳道底位置,岩浅大神经方便定位面神经迷路段。结论利用面神经与周围结构的关系,根据面神经走行特点及面神经管周围颜色、骨质改变在颞骨部位手术中能够快速准确的定位面神经,同时也可以将面神经作为其它手术的重要标志。

The clinical anatomy of the facial nerve correlated with the temporal bone surgery

Objective To study the anatomy features and the location of the facial nerve during the temporal approaches.Methods The mastoidotympanectomy,the facial recess approaches,the facial nerve decompression,the middle cranial fossa approach and the infrelabyrine approach were simulated on 15 adult cadaveric specimens(30 sides).The topographical features and the relationship of facial nerve with the surrounding structures were explored.30 dry temporal bones were cut along the facial canal,for exploring the relatio...