面神经垂直段在横、冠状断层和CT上的定位及临床意义

Thin transverse and coronal sectional anatomy and CT location of the vertical facial nerve and its clinical significance

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:30例成人头部标本,15例以眦耳线(CML)为基线,15例以CML相垂直的直线为基线,获得间隔为1.0 mm,厚度为1.0 mm的CT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1.0 mm的连续横(冠)状薄层切片。标本切片与CT图像对照,对颞骨内面神经垂直段及邻近结构进行观测。结果:(1)横断层:VFN距面神经隐窝、鼓室窦、鼓索神经、外耳道上棘距离分别为(0.63±0.15)mm、(2.17±0.12)mm、(5.16±0.10)mm和(16.80±1.19)mm;(2)冠状断层:VFN长度平均值为(14.28±1.30)mm,VFN至鼓索神经、后半规管距离分别为(2.49±0.19)mm和(2.53±0.33)mm。结论:耳颞区火棉胶横断和冠状薄层断面标本能良好显示VFN及其周围结构的解剖位置和毗邻关系,可直接与HRCT扫描图像图像进行对照研究,其结果对耳科疾病的影像诊断及手术治疗有参考价值。

Objective： To study the section anatomy and HRCT of facial nerve in the temporal bone and provide anatomic data for image diagnosis and operation treatment of this area. Mothods：30 normal adult cadaver heads were selected. 15 of them were scanned with the basic line of canthomeatal line （CML） , and other 15 were scanned with the basic line vertically to the CML respectively to obtain images of CT （1.00 mm in depth, 1.00 mm in thickness ）. And then, samples were made continuous thin transverse （coronal） sections （1.0 mm in thickness ） with the center of temporal bone. Thin sections were compared with CT data, and found out vertical facial nerve and its adjacent structures. Results： （1） On transverse sections, the distance from VFN to facial recess,sinus tympani, chorda tympani nerve and suprameatal spine was （0.63±0.15） mm, （2.17±0.12） mm, （5.16±0.10） mm and （16.80±1.19） mm respectively. （2） On the coronal sections, the length of VFN was about （14.28±1.30） mm, the distance from VFN to chorda tympani nerve and posterior semicircular canawas was （2.49±0.19） mm and （2.53±0.33） mm respectively. Conclusions： Anatomic position of VFN and its related structures can be showed clearly on transverse and coronal sections of temporal bone.. As HRCT, the result contributes to image diagnosis and operation of auris diseases.