内耳道CT三维重建及内部结构解剖学研究

Three-dimensional reconstruction of internal auditory meatus and anatomical study of the inner structures

目的 为内耳道部位的手术操作提供相应的解剖学基础。方法 用 2 5具甲醛固定的成人尸颅 (男 15具 ,女 10具 ) ,对桥小脑角和内耳道的神经、血管进行解剖学测量。另外对 13例 (2 6侧 ,男 7例 ,女 6例 )健康人行螺旋CT扫描 ,并对内耳道进行三维重建。结果 三维重建显示 :内耳道为内大外小的圆锥形 ,其水平部的宽度为 3 87～ 6 89mm ,平均 (4 16± 1 2 3)mm( x±s ,下同 ) ;垂直高度为 2 2 3～ 4 45mm ,平均 (3 14± 1 0 1)mm ;长度 6 77～ 11 2 2mm ,平均 (8 6 7± 2 31)mm ;体积为6 7 44～ 133 2 1mm3,平均 (98 2 3± 16 5 6 )mm3。解剖学测量显示小脑前下动脉形成的动脉袢突向内耳门 ,发出 1～ 4条内听动脉。内耳道中面神经的直径为 0 89～ 1 0 7mm ,平均 (0 98± 0 0 3)mm ;位听神经直径为 1 42～ 1 97mm ,平均 (1 6 7± 0 0 5 )mm ;中间神经直径为 0 19～ 0 2 6mm ,平均 (0 2 3± 0 0 2 )mm。

Objective To provide anatomical basis for surgical operation in internal auditory meatus (IAM) Methods Structures of cerebellopontine angle (CPA) and IAM in 25 temporal bone specimens (50 sides) fixed in formalin were measured Three dimensional reconstruction (3DR) of IAM in 13 normal adults (26 sides) was conducted using spiral CT scanning Results IAM took a conic shape with larger inside and smaller outside The average width of IAM was (4 16±1 23) mm(2 87 6 83 mm) in horizontal dimension, the average height was (3 14±1 01) mm(2 23 4 45 mm) in vertical dimension, the average length was (8 67±2 31) mm(6 77 11 22 mm), the average volume was (98 23±16 56) mm 3 (67 44 133 21 mm 3) There were 1 4 internal auditory arteries branched from the anterior inferior cerebellar artery, which formed a vascular ansa near the opening of IAM The average length of the facial nerve in IAM was (0 98±0 03) mm (0 89 1 07 mm), the average diameter of vestibulocochlear nerve was (1 67±0 05)mm (1 42 1 97 mm), the average diameter of the intermediate nerve (0 23±0 02) mm (0 19 0 26 mm) Conclusion It is necessary to pay attention to types of vascular ansa and relative nerve location in IAM during operation