经面神经隐窝径路显微解剖及人工耳蜗植入术的临床应用

摘要

Objective To study the anatomy of facial recess and to perform cochlear implantation via facial recess approach.Methods Thirty (60 sides) temple bone specimens were dissected to observe the dimension, shape and variation of the facialrecess.Cochlear implants were performed in 10 patients with severe sensor neural hearing loss via facial recess approach.Results Distance between the second genu of facial nerve and tympanichordal eminentia was 5.29± 0.42mm.Distance between vertical segment of facialnerve and chorda tympaninerve at level of round windowwas 2.95± 0.23mm.Distance between vertical segment of facial nerve and chorda tympani nerve at level of oval window was 3.84± 0.25mm.Distance between pyramidal eminence and round window was 3.71 ± 0.15mm.Distance between pyramidal eminence and oval window was 1.23± 0.10mm.Distance between round window and vertical segment of facial nerve was 3.82± 0.31mm.Distance between round window and oval window was 1.91± 0.16mm.The cochlear implant electrodes were inserted successfully in 10 patients.The facialnerve function were normal in all cases postoperatively.Conclusion Important anatomical landmarks of facial recess approach include round window, oval window, pyramidal eminence, facial nerve, chorda tympani nerve and lateral semicircular canals, which are essential for insertion of cochlear implant electrodes.%目的 观察经面神经隐窝径路的局部显微解剖结构,并探讨其在人工耳蜗植入术中的临床应用.方法 对30例(60侧)国人尸体头颅进行面神经隐窝的显微解剖测量;经面神经隐窝入路,对10例重度感音神经性耳聋患者施行人工耳蜗植入术.结果 面神经锥段到鼓索隆起距离为(5.29±0.42)mm;在圆窗、卵圆窗平面,面神经乳突段到鼓索神经的距离分别为(2.95±0.23)mm和(3.84±0.25)mm;锥隆起到圆窗龛和卵圆窗的距离分别为(3.71±0.15)mm和(1.23±0.10)mm;圆窗龛到面神经乳突段距离为(3.82±0.31)mm;卵圆窗到圆窗龛距离为(1.91±0.16)mm.10例耳聋患者均经面神经隐窝径路成功植入了人工耳蜗,术后无并发症发生.结论 圆窗龛、卵圆窗、锥隆起、面神经、鼓索神经、水平半规管等是经面神经隐窝径路的重要解剖标志,掌握此局部显微解剖结构将有助于经面神经隐窝径路施行人工耳蜗植入术.