面神经管及邻近结构在横断薄层切片与高分辨率计算机断层摄影图像的对照

Contrast between sectional anatomy and high-resolution computed tomography image of temporal bone including inner segment of facial nerve canal and adjacent structures

目的:为面神经及耳科病变的影像诊断和手术治疗提供解剖学基础。方法:15例成人头部标本,以眦耳线(CML)为基线,获得间隔为1.0mm,厚度为1.0mm的高分辨率计算机断层摄影(HRCT)图像,扫描后的头部标本按原定位截取以耳颞区为中心的组织块并将其制成厚为1.0mm的连续横断簿层切片。标本切片与HRCT图像对照,对颞骨内面神经、听小骨、骨半规管、前庭、耳蜗等结构进行观测。结果:面神经膝状神经节(GG)多位于外半规管层面;匙突多与锤砧关节位于同一层面;锥隆起多位于鼓岬层面。结论:面神经水平段起始部、OG、面神经迷路段三者在外半规管层面内呈倒"V"字型排列;面神经垂直段位于面神经隐窝深面,面神经隐窝、锥隆起、锥隐窝三者在鼓岬层面内从内向外呈"ω"字型排列。

Objective. To study the sectional anatomy and the high-resolution computed tomography （HRCT） of facial nerve in the temporal bone and provide anatomical data for image diagnosis and operation treatment of this area. Methods： 15 normal adult cadaver heads were scanned taking canthomeatal line （CIVIL） as basic line to obtain images of HRCT （1.0 mm in depth, 1.0 mm in thickness）. And then, those samples were used to make continuative thin sections （1.0 mm in thickness） taking temporal bone as the center. Compared with HRCT scans, all the intratemporal regions of facial nerve, auditory ossicles, osseous semicircular canals, vestibule, cochlea et al were observed. Results： The geniculate ganglion （GG） was in the layer of lateral semicircular canal; Cochleariform process was in the same layer with malleoincudal articulation; pyramidal eminence laid in the same layer with promontory. Conclusion： The labyrinthine segment of facial nerve, GG and the first part of horizontal segment of facial nerve present a reverse V-shape in the layer of lateral semicircular canal. Vertical part of facial nerve locates deeply in the facial recess. Facial recess, pyramidal eminence, and sinus tympani look like a ＂to＂-shaped pattern in the promontory lcayer.