面神经颞骨内段在冠状薄层切片与高分辨率计算机断层摄影图像上的应用解剖

Applied anatomy between thin coronal sectional specimens and high-resolution computed tomography images of temporal bone including inner segment of facial nerve 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，以与呲耳线（CML）相垂直的直线为基线，获得间隔为1．0mm，厚度为1．0mm的高分辨率计算机断层摄影术（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的连续冠状薄层切片。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：颞骨冠状HRCT扫描，有30-32层，膝状神经节居第5～7层，面神经水平段起始部和面神经迷路段居第7～8层，面神经垂直段居第16～17层，面神经隐窝、锥隆起、锥隐窝三者在第14-15层从外向内呈“M”字型排列。结论：耳颞区火棉胶冠状薄层断面标本能良好显示面神经及其周围结构的解剖位置和毗邻关系，可直接与高分辨率CT冠状扫描图像进行对照研究，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 high-resolution computed tomography （HRCT） of facial nerve in the temporal bone and to provide anatomical basis for image diagnosis and operation treatment of this area. Methods： 15 normal appearance cadaver head were scanned by a line which was vertical to the canthomeatal line（CML） as basic line to obtain images of HRCT （1.0 inm in depth, 1.0 mm in thickness）. Continuative thin coronal sections （1.0 mm in thickness） were made. The structures within intratemporal region including the facial nerve, auditory ossicle, osseous semicircular canals, vestibule, cochlea and soon were scanned with HRCT. Results： There were about 30-32 layers of temporal scans on the HRCT image. The geniculate ganglion appeared on the 5-7th layers, while the labyrinthine and horizontal segments of facial nerve and the vertical segment of facial nerve appeared on the 7-Sth layers and 16-17th layers respectively. Facial recess, py- ramidal eminence and sinus tympani which looked like a ＂M＂ were found on the 14-15th layers. Conclusion： The thin coronal section specimen of temporal bone could show the anatomical position between the facial nerve and its related structure well. Compared with the HRCT, the results contribute to the imaging diagnosis and the operations of the auris disease.