人工耳蜗植入中的相关解剖与面神经功能保护

目的对人工耳蜗植入手术相关的部分解剖结构进行观察、测量,找出与手术相关的因素,为临床开展人工耳蜗植入手术提供理论参考.方法取成人颞骨40侧(左23,右17),在手术显微镜下观察、测量了锥隆起及面神经管的高度、面隐窝和鼓室窦的深度.结果锥隆起的高度为(2.2±0.07)mm,面神经骨管的高度为(3.8±0.1)mm,面隐窝的深度为(1.8±0.09)mm,鼓室窦的深度为(2.9±0.11)mm,统计学表明锥隆起与面隐窝有相关性(R=0.55,t=3.82),因此两者有显著性意义(P＜0.01).结论锥隆起不仅为后鼓室的重要解剖标志,也为面神经第2膝、茎突复合体、4个隐窝和5个骨嵴的解剖标志,并且锥隆起越高面隐窝相应的越深.文中数据为中耳手术提供了更多的参考数据.对手术中避免面神经等重要结构的损伤有重要意义.

Morphologic study of the adjacent structures in artificial cochlea implantation and their correlation with facial nerve

AIM: To define anatomical relationships important in cochlear implantation with morphometry of the adjacent structures so as to provide theoretical foundation for extended clinical application.METHODS: Microanatomical study was carried out on 40 adult temporal bones with operation microscope to measure the height of pyramidal eminence (PE) and facial nerve canal(FNC), and the depth of facial recess(FR) and tympanic sinus(TS).RESULTS: The height of PE and FNC were(2. 2 +0.07) mm and(2.2 +0.07) mm, and the depth of FR and TS were(1.8 +0.09) mm and (2.9 +0. 11 ) mm respectively. Statistical analysis has proved the correlation of PE with FR( R = 0. 55, t = 3.82), which is of significance( P ＜ 0.01 ).CONCLUSION: PE was an important anatomical landmark not only with respect to posterior tympanic, but also to the second genu of facial nerve (FN), styloid complex, four recesses and five bone ridges, whose height has positive relation with the depth of FR. The results obtained in this study supplement our knowledge of the anatomy of the middle ear, which was of great importance in avoiding possible trauma of facial nerve and other adjacent structure during operation.