论文部分内容阅读
目的 为经岩骨入路手术中保护迷路提供显微解剖学资料。方法 模拟幕上下联合经岩骨入路的手术操作 ,在手术显微镜下对 10具 ( 2 0侧 )福尔马林固定的成人带颈头颅标本进行解剖 ,并观测骨迷路及其与重要结构间的解剖关系。结果 骨迷路为一块包绕膜迷路的质地致密、色泽亮丽的骨质 ,并构成乳突气房的内侧边界。磨削骨半规管透过菲薄的骨质显示暗蓝色的膜半规管即为“蓝线”。测量骨迷路与周围结构的距离有较大的个体差异 ,其中后半规管至岩骨后表面的距离 3.1mm± 1.3mm ,至乙状窦前缘的距离 8.6mm± 2 .2mm ;上半规管至岩骨上表面的距离 1.5mm± 0 .7mm ,总脚至岩骨后表面的距离 3.4mm± 1.4mm。根据乳突气房发育程度将乳突简单分为 :①气化型 ;②非气化型。气化型乳突者迷路的确认及保护较为容易 ,反之则困难。结论 经岩骨入路时 ,迷路在岩骨中的位置和乳突气化的程度是影响迷路保护的主要解剖学因素。一般而言 ,术中根据骨质的质地和色泽确认骨半规管并且不逾越“蓝线”对保护迷路的完整极为重要。
Objective To provide anatomical data for the protection of the lost through the operation of petrous bone. Methods A total of 10 adults (20 sides) formalin-fixed adult patients with neck skull were dissected under a surgical microscope under the operation of supratentorial and supratentorial procedures. Anatomy. Results The bony labyrinth was a compact, brightly-colored bone that surrounded the labyrinth and formed the medial border of the mastoid atrium. Abrasive bone semicircular canal through the meager bone shows dark blue membrane semicircular canal is the “blue line.” There was a large individual difference in the distance between the bony labyrinth and the surrounding structures. The distance between the posterior semicircular canal and the posterior surface of the petrous bone was 3.1 mm ± 1.3 mm and the distance to the sigmoid sinus front was 8.6 mm ± 2.2 mm. The distance between the upper surface of the bone and the back surface of the petrous bone is 1.5mm ± 0 .7mm and 3.4mm ± 1.4mm. Breast process according to the degree of development of mastoid mastoid is divided into simple: ① gasification; ② non-gasification type. Gasification mastoid who lost confirmation and protection easier, and vice versa is difficult. Conclusions The location of malunion and the degree of mastoid gasification in the petrous bone are the main anatomic factors that affect the labyrinthine approach when transpedicate. In general, identifying the semicircular canal during surgery based on the texture and color of the bone and not exceeding the “blue line” is extremely important for the protection of the lost.