基于CT的前庭蜗器断层解剖研究

目的从形态学角度阐述前庭蜗器断层解剖的微细结构,为人工耳蜗植入术和相关工作提供参考.方法采用火棉胶切片制作法,分水平位和冠状位切片并与CT断层扫描方位一致,选择代表性层面进行观察描述.水平位自下而上分蜗窗龛、蜗窗、锤骨柄、锤骨颈、锥隆起、面神经鼓室段、面神经膝、外半规管等8个层面描述;冠状位自前向后分耳蜗、前庭窗、蜗窗、面神经乳突段等4个层面描述.结果观察前庭蜗器各断层解剖的微细结构,并将火棉胶切片与CT扫描图像相对照,显示面神经迷路段终段、面神经膝和面神经鼓室段起始部与耳蜗中间周、基底周关系密切,将水平位切片与冠状位切片相结合,可全面显示面神经与耳蜗的位置关系,经比较水平位切片更具优势.冠状位切片可清晰的显示出蜗窗龛和蜗窗的解剖结构.结论通过分析研究面神经与耳蜗的位置关系以及蜗窗龛和蜗窗的解剖结构,对避免人工耳蜗植入术中对面神经的损伤和耳蜗钻孔位置定位及电极插入等都具有极大的帮助.

Sectional anatomical study on vestibulocochlear organ based on CT slices

OBJECTIVE To describe the sectional anatomy of the fine structures of vestibulococholear organ and provide reference for cochlear implantation and related work. METHODS Specimens embedded by cellodion were sliced by horizontal and coronal section in accordance with CT scan. Representative slices were selected and described. Eight horizontal planes from inferior to superior were described including cochlear window niche, cochlear window, manubrium mallei, malleus neck, pyramidal eminence, tympani segment of facial nerve, geniculum of facial nerve, and lateral semicircular canal. Four coronal planes from anterior to posterior were described including cochlear, vestibular window, cochlear window, and mastoid segment of facial nerve. RESULTS Referring to CT scan, the fine structures of each cellodion section of vestibulococholear organ were observed clearly. The terminal part of labyrinthine segment of facial nerve, geniculum of facial nerve, and initial part of tympani segment of facial nerve are closely related to middle and basal turn of cochlear. The combination of horizontal and coronal plane can display the anatomical relationship between facial nerve and cochlear more comprehensively, but the horizontal plane is more advantageous. The coronal plane can show the anatomy of cochlear window niche and cochlear window clearly. CONCLUSION By analyzing the relationship between facial nerve and cochlear and studying the anatomy of cochlear window niche and cochlear window, it will be helpful to locate the position of drilling and electrode insertion correctly and prevent facial nerve damage in cochlear implantation.