中耳手术面神经定位的研究进展

The Landmark of Facial Nerve in Current Progression of Middle Ear Surgery

近年来,随着手术显微镜和电钻的问世,中耳手术面神经损伤率大大降低,但即使是非常有经验的医生也不可避免地有损伤面神经的机会,尤其是当患者为再次手术,或合并感染、胆脂瘤等使正常解剖标志改变、模糊或移位,或先天性畸形者,都会增加手术损伤面神经的机会。本文主要是针对中耳手术面神经定位的研究进展做简要的综述。中耳手术面神经的定位主要是依靠中耳面神经的解剖学标志,例如匙突、砧骨短突、水平半规管、二腹肌脊、鼓索神经等。随着影像学的高速发展,特别是高分辨率CT以及CT的多平面重建(MPR)和曲面重建(CPR)等,对面神经的定位有明显的指导意义。同时熟悉面神经的畸形以及面神经监测技术的开展,对面神经的定位也有一定的帮助。了解国际上中耳手术面神经定位的研究进展,对于面神经的定位、降低中耳术后面神经损伤的概率有着十分重要的意义。

In recent years, with the advent of the operating microscope and drill, the facial nerve injury rate in middle ear surgery is much lower. But even the very experienced doctors inevitably have the chance to damage the facial nerve. Especially when the patient was re-surgery, infection or cholesteatoma which would make the thenormal anatomic landmarks changed, blurred or shifted, and the congenital deformity, they all increased the chance of facial nerve injury. This article is for the landmark of facial nerve in the middle ear surgery to make a brief overview of research progress. The landmark of facial nerve in the middle ear surgery mainly relies on the anatomy of the facial nerve in the middle ear, such as eochleariform process, processus brevis incudis, horizontal semicircular canal, digastric ridge, chorda tympani nerve and so on. With the rapid development of imaging, especially the application of the HRCT, MPR and CPR, has obvious significance in the landmark of facial nerve. Familiar with facial deformities and the carrying out of the facial nerve monitoring technology has some help in the landmark of facial nerve. Understanding of the international research progress of the landmark of facial nerve in the middle ear surgery has great significance in the landmark of facial nerve and the reducing of the probability of facial nerve injury.