前庭小管外口的形态特点及其临床意义

Applied anatomy of the external aperture of the vestibular aqueduct and its clinical significance

目的 :研究前庭小管的形态及毗邻关系 ,为经岩骨临床手术提供解剖学依据。方法 :在 32例( 6 4侧 )新鲜颅底标本上观察前庭小管的形状 ,并测量其长度及其到内听孔下后缘、乙状窦前缘、岩骨嵴、颈静脉孔上缘的距离 ,对比双侧的差异。结果 :前庭小管多为弧形 ( 4 8% ) ,其次为S型 ( 2 8% ) ,折线形最少 ;前庭小管长度及其到内听孔下后缘、乙状窦前缘、岩骨嵴、颈静脉孔上缘的距离平均值分别为 :9.7、1 0 .7、9.6、8.8和 9.5mm ,其中到乙状窦和颈静脉孔的距离两侧有显著性差异 ,均以右侧较短。结论 :前庭小管是经岩骨手术的重要解剖标志 ,国人和国外人种在解剖上存在一定差异 ,乙状窦前置和高颈静脉以右侧多见。

Objective: To provide anatomic basis for transpetrous approach surgery.Methods; The configurations of external aperture of the vestibular aqueduct (EAVA) were observed on 32 fresh skull base specimens (64 sides), their lengths and the distances from EAVA to inferior posterior margin of interior acoustic port, to anterior edge of sigmoid sinus, to petrous ridge and to jugular foramen were measured respectively, the differences between the left and right sides were contrasted.Results: The shapes of EAVA were arched in 48% of all, S shape in 28%, folding line shape in 24%; the mean length of EAVA and the mean distances from EAVA to inferior posteror margin of interior acoustic port, to anterior edge of sigmoid sinus, to petrous ridge and to jugular foramen were 9.7,10.7,9.6,8.8 and 9.5 mm in turn.There were significant differences between left and right sides in the distances from EAVA to anterior edge of sigmoid sinus ( P <0.01) and to jugular foramen ( P =0.05), the distances to right sides were shorter.Conclusion: EAVA is a significant anatomy mark on the posterior surface of petrous bone and there are some differences between countrymen and foreigners.Prepositus sigmoid sinus and high jugular buld often appear at right side.