中间神经的显微解剖研究

Microanatomy study and clinical significance on intermedius nervus

目的 探讨中间神经的显微解剖形态与毗邻组织结构的关系。方法 选择经 10 %福尔马林固定血管内灌注混有彩色乳胶的成人尸头 16具。结合听神经鞘瘤三种手术入路 ,在手术显微镜下 ,观测不同部位的中间神经。结果 中间神经分为桥小脑角段 ,内听道段和面神经管段。桥小脑角段与毗邻的关系不恒定 ,内听动脉与中间神经位置相对恒定 ,乙状窦前经迷路入路和颞下经岩入路可以较好地显露中间神经。结论 了解中间神经的显微解剖形态 ,可以正确选择手术入路 ,避免神经损伤 ;

Objective To explore microanatomical shape on intermidius nervus and its relations to adjacent tissure and structures.Methods 16 adult cavaders were fixed and perfused with color silicon, Intermedius nerus were observed and measured under the operative microscope according to three kinds of operative approaches on acoustic neuroma. Results Intermedius nervus were divided into three phasees such as cerebropontine angle, internal acoustic meatus and fallopins aduct. The position on intermedius nervus changed in cerebellopontine angle, while there were significance relations between internal acoustic artery and intermedius nervus. Good exposure presented in presigmoid translabyrinthine approach and subtemporal transpetrosal approach.Conclusions Our study shows that know clearly the shapes and location on intermedius nervus is benefit to select better operative approaches and avoid to damage. Preseving intermedius nervus are as protect same inportment as facial nerve motor branches during the operation.