内耳的显微解剖及临床应用

目的了解内耳及相邻结构的显微解剖,为术中切除岩骨骨质提供解剖学参数.方法在显微镜下对15例成人尸头标本的内耳及相邻结构进行解剖学测量.结果乙状窦沟、内听道孔、颈静脉孔、耳蜗、岩嵴和后半规管最后点等可作为手术标志.后半规管最后点和内听道孔后缘到乙状窦沟距离为9.8mm及22.0mm,岩骨后面到面神经管垂直部距离9.1mm,岩嵴到颈静脉球窝顶距离15.1mm,岩嵴最后点到耳蜗距离为28.6mm.结论熟练掌握内耳及相邻结构的解剖,严格限制骨质切除范围,就能既得到满意的手术暴露,又不引起更多并发症.

Microanatomy of the inner ear and clinical application

Objective To understand the microanatomy of the inner ear and adjacent structures and to supply anatomical parameters for the removal of the petrosal bone during the operation. Methods The anatomical measurement of the inner ear and adjacent structures were studied in 15 adult cadaver temple bones under the microscope. Results The sigmoid sinus, internal auditory porus, jugular porus, cochlea, petrous ridge and the most posterior point of the posterior semicircular canal could be markers of surgery. The distances between the most posterior point of the posterior semicircular canal and posterior margin of internal auditory porus and the sigmoid sinus were 9.8 mm and 22.0 mm ; The distance between the posterior pyramidal wall and vertical segment of the facial nerve canal was 9.1 mm ; The distance between the petrous ridge and the apex of the jugular bulb was 15.1 mm ; The distance between most posterior point of petrous ridge and the cochlea was 28.6 mm . Conclusion A skillful master of the anatomy of the inner ear and adjacent structures, and a strict limit to the size of osteotomy, enble us to have an appropriate exposure without too many complications.