内淋巴囊外科手术应用解剖及其意义

The Surgical Anatomy of the Endolymphatic Sac and its Significance

目的研究内淋巴囊的形态、定位等外科手术应用解剖,为内淋巴囊手术提供解剖学基础。方法15例甲醛固定后的成人头颅(30耳),游标卡尺和量规测量内淋巴囊的长度和宽度,内淋巴囊中心、上、下缘与手术时各个标志的距离。结果内淋巴囊的平均长度和宽度分别为8.9±3.2 mm、9.1±2.8 mm,内淋巴囊中心、最高点、最低点至砧骨短脚、面神经垂直段最后缘、外耳道后壁内侧中点、后半规管最上和最下缘、外半规管最上缘的距离分别为15.5±3.2、11.1±2.6、13.3±3.2、16.2±3.8、7.5±2.5、2.1±0.9、14.1±2.5、12.2±2.7、15.2±2.3、14.6±2.4、2.3±0.8、1.8±0.7、17.2±1.8、12.2±2.4、14.3±2.5、17.5±1.6、12.5±2.4、5.2±1.4 mm。结论本文结果有助于乳突人路内淋巴囊减压或引流定位内淋巴囊,避免面瘫和听力损害等并发症的产生。

Purpose To study the sttrgical anatomy of the endolymphatic sac for the functional surgery of Meniere's disease.Methods The mastoids of 15 adult cadaver were skeletonized and the endolymphatic sacs were entirely exposed. The distance of the the endolymphatic sacs and the important structures of middle ear and inner ear were measured.Results The mean length and width of the endolymphatic sacs were 8.9±3.2 mm(superior to inferior) and 9.1±2.8 mm (anterior to posterior) respecthvely.The mean distance between the center of the endolymphatic sac (the superior of the endolymphatic sac,the inferior of the endolymphatic sac)and the short process of the incus,the vertical segment of fallopian aqueduct,the median of the posterior external acoustical canal,the superior and inferior of posterior semicircular canal,and the superior of the lateral semicircular canal were 15.5±3.2,11.1±2.6,13.3±3.2,16.2±3.8,7.5±2.5,2.1±0.9,14.1±2.5,12.2 ±2.7,15.2±2.3,14.6±2.4,2.3±0.8,1.8±0.7,17.2±1.8,12.2±2.4,14.3±2.5,17.5±1.6,12.5±2.4 and 5.2 ±1.4 mm separately.Conclusion The results will help us to locate the site of the endolymphatic sac through the mastoid and avoid the complications such as the facial paralysis and hearing loss during operation.