摘要
目的 为经岩骨入路保护面神经提供显微解剖学资料。方法 手术显微镜下对 10具 (2 0侧 )福尔马林固定的成人头颈部标本模拟经岩骨入路的手术操作 ,观测管段面神经的解剖及其与重要结构的关系。结果 管段面神经分 3段 :迷路段长 (3.2± 0 .9)mm ,上下方向管径 (1.1± 0 .2 )mm ;鼓室段长 (11.7± 1.5 )mm ,水平方向管径 (1.4± 0 .1)mm ,两段成角 71.0°± 11.7° ;垂直段长 (13.9± 1.8)mm ,前后方向管径 (1.6± 0 .2 )mm ,与水平段成角 10 6 .6°± 7.7°。管段面神经的解剖标志 :①锥隆起是上膝部的标志 ,锥隆起与茎乳孔连线为垂直段的标志线 ;②面神经裂孔是膝状神经节的标志 ;③垂直段距离海伦嵴 (15 .0± 1.3)mm。结论 熟悉管段面神经的解剖特点和标志 ,有利于手术中保护面神经。
Objective To provide the anatomic base for protecting the facial nerve in the transpetrosal approach. Methods On 20 sides of 10 adult cadaver heads fixed in formalin, the anatomy of the facial nerve and the relationship of related structures were observed and measured by mimicking the actual surgical procedure under surgical microscope. Results The facial nerve canal may be divided into 3 portions: the labyrinthine, the tympanic and the mastoid. Lengths of the 3 portions were ( 3.2± 0.9)mm, ( 11.7± 1.5)mm and ( 13.9± 1.8)mm; diameters of the 3 portions were ( 1.1± 0.2)mm, ( 1.4± 0.1)mm and ( 1.6± 0.2)mm, respectively. The facial nerve canal measurements included angle for the first genu, which was 71.0°± 11.7°, and the second genu had an angle of 106.6°± 7.7°. The anatomic landmarks of the facial nerve were: ①Pyramidal eminence was the landmark of the second genu, while the line between it and stylomastoid forma was the landmark of the mastoid portion; ② The facial hiatus of the temporal bone was an important landmark in recognizing the geniculate ganglion; ③ The distance from the mastoid portion to the Henlen's spine was ( 5.0± 1.3)mm. Conclusion Learning the anatomic landmarks and characteristics of the facial nerve by heart would help to protect the nerve.
出处
《中国耳鼻咽喉颅底外科杂志》
CAS
2001年第4期214-216,I007,共4页
Chinese Journal of Otorhinolaryngology-skull Base Surgery
