人工耳蜗植入术鼓阶入口定位的相关解剖研究

Applied anatomy of scala tympani inlet related to cochlear implantation

目的通过对人工耳蜗植入手术相关的后鼓室及上鼓室解剖结构进行观察、测量,为人工耳蜗植入手术中顺利找到并准确定位鼓阶入口提供理论参考。方法对20侧成人颞骨标本进行解剖,模拟人工耳蜗植入术,在手术显微镜下观察、测量与人工耳蜗植入手术相关的解剖数据。结果砧骨短脚至圆窗龛之间的距离为(5.91±0.29)mm;镫骨头至圆窗龛之间的距离为(2.11±0.18)mm;面神经垂直段至圆窗龛之间的距离为(6.70±0.19)mm;锥隆起至圆窗膜前缘之间的距离为(2.22±0.21)mm;镫骨头至圆窗膜下缘之间的距离为(2.16±0.14)mm;鼓阶入口与卵圆窗最近距离为(2.12±0.19)mm;匙状突至圆窗龛之间的距离为(3.79±0.17)mm;镫骨头至耳蜗第二回切开点之间距离为(2.25±0.13)mm;锥隆起至耳蜗第二回转切开点之间距离为(2.28±0.20)mm。结论人工耳蜗植入手术中切开耳蜗底回的位置位于锥隆起前下方约2.22 mm处;切开耳蜗第二回的位置位于锥隆起前上方约2.28 mm处;根据病人不同情况,为术中选择不同的鼓阶切开点提供了参考。

Objective To investigate the related parameters of the temporal bone structure for determining the position of implanting electrode into the scala tympani in cochlear implantation surgery through the facial recess and epitympanum approach. Methods In a surgical simulation experiment, 20 human temporal bones were studied and measured to determine the related parameters of the temporal bone structure. Results The distance 5.91±0.29 mm between the short process of the incus and the round window niche, 2.11±0.18 mm between the stapes and the round window niche, 6.70±0.19 mm between the facial nerve in the perpendicular paragraph and the round window niche, 2.22±0.21 mm from the pyramidal eminence to the round window, and 2.16±0.14 mm between the stapes and the round window. The minimal distance between the implanting electrode and the vestibular window was 2.12 ± 0.19 mm. The distance between the cochleariform process and the round window niche was 3.79±0.17 ram. The position of the cochlear electrode array insertion into the second cochlear turn was 2.25± 0.13 mm under the stapes. The location of the cochlear electrode array insertion into the second cochlear turn was 2.28±0.20 mm inferior to the pyramidal eminence. Conclusion These parameters provide a reference value to determine the different positions of cochlear electrode array insertion into the scale tympani in different patients.