内窥镜下迷路后入路面神经解剖学研究

Endoscopic anatomic study on facial nerve through retrolabyrithine approach

目的:为内窥镜下迷路后入路面肌痉挛微血管减压术提供解剖学资料。方法:正常成人头颅标本15例(30侧),模拟迷路后入路在内窥镜下观察面神经及其与前庭蜗神经和相关血管的毗邻关系。结果:(1)在不牵拉小脑和不损伤内耳结构的前提下,内窥镜下迷路后入路可观察小脑脑桥角区面神经全程;(2)面神经根出入区位于前庭蜗神经内侧稍下方;(3)有13.3%小脑下前动脉袢呈环状围绕面神经,26.7%小脑下后动脉与面神经位置关系密切。结论:内窥镜下迷路后入路对小脑脑桥角区面神经及微血管的处理有极好视角。

Objective： To provide anatomic basis for microvascular decompression of hemifacial spasm through retrolabyrinthine approach under endoscope. Methods：The facial nerve and its adjacent structures in the CPA were observed in 30 sides of adult cadaver head specimens with the retrolabyrinthine approach underwent through endoscope. Results： （1） Endoscopic retrolabyrinthine approach could expose the facial nerve and its adjacent structures effectively, without retracting cerebellum and doing damage to the structures of the internal ear. （2） Root entry or exit zone of the facial nerve was located medial and slightly inferior to that of the vestibulocochlear nerve, （3）The facial nerve was wrapped by the circular anterior inferior cerebellar artery in 13.3%. The rate of the loop of posterior inferior cerebellar artery closed to the facial nerve was about 26.7%. Conclusions： Endoscopic retrolabyrinthine approach has an excellent visual angle in dealing with the facial nerve and related micro-vessels in the CPA.