国人颞骨内主要骨管的形态观测及其临床意义

Morphological Observations and Measurements on Main Canals in Temporal Bone of Chinese and Their Clinical Significance

目的:为颞骨骨管内结构疾病的影像诊断及手术治疗提供解剖学依据．方法:利用探针及游标卡尺测量各骨管的有关数据．结果:咽鼓管骨部长10．40 mm,鼓室口4．46 mm×3．58 mm,峡部开口2．31 mm× 1．45 mm;岩大神经管长13．93 mm;鼓膜张肌半管长11．86 mm;颈动脉管垂直段高7．51 mm,水平段长15．79 mm;岩磷裂长7．25 mm,鳞鼓裂长13．88 mm,岩鼓裂管长5．68 mm,岩鼓裂管颅底开口距下颌窝中央7．42 mm．结论:经乳突咽鼓管骨部手术扩张管腔时应防止损伤其毗邻结构;颅中窝手术在分离颞骨岩部前面覆盖的硬脑膜时,注意不要损伤岩大神经和膝神经节;颞下颌关节的病变通过穿行岩鼓裂管的结构可能会影响中耳的功能．

Objective：To provide anatomical bases for the diagnosis and operative treatment of disease of the structures in the canals of temporal bone. Methods： The data of each canal were obtained with probe and slide gaud. Results： The bony portion of auditory tube averages 10.40 mm in length, its tympanic opening has an average dimension of 4.46 mm×3.58 mm,and the average dimension of isthmic opening is 2.31 mm × 1.45 mm. The length of canal for greater petrosal nerve and of semicanal for tensor tympani is 13.93 mm and 11.86 mm respectively. The height of the vertical portion of carotid canal is 7.51 mm,and it has the length of 15.79 mm in its horizontal portion. The length of fissura petrosquamosa, squamotympanic fissure and petrotympanic rimule is 7.25 mm, 13.88 mm and 5.68 mm respectively. The distance between the opening of petrotympanic rimule on the external surface of the base of skull and the center of mandibular fossa averages 7.42 ram. Conclusion： It is important to avoid the damage to the adjoining structures close to the bony portion of auditory tube while transmastoid approach is applied to expand the lumen of auditory tube. Surgeon should be cautious of impairing greater petrosal nerve and genicu- late ganglion when he segregates the dura over anterior surface of petrous part. The lesion of temporomandibular joint may affect the function of middle ear through the structures passing through petrotympanic rimule.