经颞骨入路手术避免面神经垂直部损伤的相关解剖学数据测量

Measurement of Related Anatomy Data on Temporal Bone Surgery Route to Avoid Vertical Facial Nerve Injuries

目的：通过对相关解剖结构的影像观察、测量，探讨经颞骨入路手术中如何避免损伤面神经垂直部。方法：采用16层螺旋cT对68人（136侧），其中女性33例（66侧），男性35例（70侧）行颌面部轴位CT扫描。在横断位分别测量面神经管垂直部至外耳道后壁（D1）、外耳门后缘（D2）、乙状窦沟前壁（D3）、颈静脉窝（D4）的水平距离，以及外耳道后壁至乙状窦沟前壁之间水平距离（D5）。结果：D1～D15分别为：（2．87±0．47）mm，（11．09±2．30）mm，（7．95±2．15）mm，（5．45±2．32）mm，（13．48±2．19）mm。面神经垂直部至颈静脉窝之间水平距离左右两侧间差异有统计学意义（P〈0．05），性别之间差异无统计学意义（P〉0．05）；其余各项指标测量结果侧别差异无统计学意义（P〉0．05），性别差异有统计学意义（P〈0．05）。结论：通过断层影像解剖学观测，获得了经颞骨入路手术相关结构的解剖学数据，该组数据可为术中避免面神经等重要结构的损伤提供参考。

Objective： To observe and measure the anatomical structure of the approach for the temporal bone surgery in order to provide a theoretical reference for the temporal bone surgery route. Methods：To evaluate the accuracy of CT image of related structure, 16 spiral CT was adopted to scan 68 patients （ 136 sides） with non-ear disorders, among them, 33 females （66 sides） and 35 males （70 sides）. They were subjected to maxillofacial HRCT scan and the horizontal distances of the facial nerve canal to the posterior wall of external acoustic meatus, the rear edge of external ear, sulci sigmoideus and the jugular fossa, as well as the horizontal distance between the posterior wall of external acoustic meatus and sulci sigmoideus were measured. Results： In the distance of the facial nerve canal to the jugular fossa, there was significant difference between left side and right side （P 〈 0.05）, while no significant difference between genders （P 〉 0. 05）. However, in the other distance, there was no significant difference between left side and right side （P 〉 0.05 ）, but there was signifi- cant difference between genders （ P 〈 0.05 ）. Conclusions： The data obtained from this study can provide reference for temporal bone surgery route to avoid vertical facial nerve injuries.