内耳门周结构对内镜下脑桥小脑三角区手术的影响

目的：研究内耳门周结构对颞骨径路内镜下处理脑桥小脑三角区病变手术的影响，为临床开展相应手术提供参考。方法：在20例40侧成人尸头上模拟颞骨径路内窥镜手术，观察小脑下前动脉及内耳门后唇的变异，了解其对内窥镜导入及其手术的影响。结果：内耳门后唇隆起超过面神经脑桥小脑角段1／3以上者占27．5％(11侧)。小脑下前动脉在Ⅶ、Ⅷ脑神经外侧成袢者占22．5％(9侧)。内耳门后唇隆起合并小脑下前动脉袢在Ⅶ、Ⅷ脑神经之外侧者占7．5％(3侧)。结论：当内耳门后唇隆起超过面神经脑桥小脑角段1／3或小脑下前动脉弓在Ⅶ、Ⅷ脑神经之前时将对内窥镜导入有阻碍，当两种情况合并存在时要将内窥镜导入脑桥小脑三角区相当困难，不宜采用此种手术方式。

Effects of the surrounding structures of internal acoustic pore on cerebellopontine angle surgery aided by endoscope

Objective: To study the effects of surrounding structures of internal acoustic pore on petroclival surgery aided by endoscope. Method: To simulate the surgery in 20 adult cadaveric specimens (40 sides), observe anterior inferior cerebellar artery and posterior lip of internal acoustic pore, and study the effect of them on cerebellopontine angle surgery aided by endoscope. Results: In 11 sides (27.5%), posterior lips of internal acoustic pore covered 1/3 or more facial nerve. In 9 sides (22.5%), anterior inferior cerebellar arterial arch located in lateral of facial nerve. Both of them occurred in 3 sides (7.5%). Conclusion: When the posterior lip of internal acoustic pore covers 1/3 or more facial nerve or anterior inferior cerebellar artery locates in the lateral of facial nerve, the surgery gets more difficult. If both of the two situations occurred, it is better not to start the surgery.