经颅中窝人工耳蜗植入开窗点定位的解剖学研究

Anatomy of Fenestration Site for Trans-Middle Fossa Cochlear Implantation

目的通过尸头颅中窝耳蜗的解剖及测量,探索出经颅中窝底板耳蜗开窗点的表浅定位方法,并对耳蜗周围结构解剖观测。方法对20具成人尸头模拟经颅中窝入路开颅,在颅中窝底板下对耳蜗底转轮廓化并开窗;对耳蜗底转及其与周围结构的关系相关结构解剖测量与统计,探索经颅中窝人工耳蜗植入耳蜗开窗点的定位方法。结果通过对耳蜗底转轮廓化后以耳蜗底转最表浅点内侧,距迷路段面神经及颈内动脉最远点为开窗点(W点):1、弓状隆起与岩浅大神经所组成的角(顶点为O点)为119.80±2.65度;2、W点经O点与弓状隆起组成的角为81.40±3.40度,与岩浅大神经所组成的角为38.45±2.46度;3、O点至W点的距离为10.71±0.65mm;4、岩浅大神经与W点的距离为3.77±0.29mm;5、面神经迷路段与W点的距离为3.75±0.21mm;6、颈内动脉与W点的距离为4.95±0.26mm;7、颅中窝底板与W点的垂直距离为2.77±0.28mm。结论颅中窝耳蜗底转开窗点(W点):W点距离"O"点(由弓状隆起长轴与岩浅大神经延长线相交点)10.71±0.63mm,与弓状隆起长轴呈81.40±3.32度、与岩浅大神经成38.45±2.40度。

Objective To study and measure anatomical structures around the cochlea and identify a methodology for determination of the location of fenestration to the cochlea on the middle fossa floor.Methods Middle fossa craniotomy was performed on 20 adult cadaveric heads.The cochlea was skeletonized and opened under middle cranial fossa floor and the basal turn and its relationship with the surrounding structures were measured to determine the location of fenestration for trans-middle fossa cochlear implantation.Result Through the reconstruction of the base of the cochlea,the most superficial part of the cochlea is transferred to the inside,and the farthest point from the labyrinthine facial nerve and the internal carotid artery is the window point(W point):1 The angle between the arcuate eminence and the superficial petrosal nerve(point O)was 119.80+2.65 degrees;2)the angle between the line from point W to point O and the arcuate eminence was 81.40±3.40 degrees,and 38.45±2.46.3 degrees between the line and the superficial great petrosal nerve;3)the distance from point O to point W was 10.71±0.65 mm;4)the distance between the superficial great petrosal nerve and point W was 3.77±0.29 mm;5)the distance between the labyrinthine facial nerve and point W was 3.75±0.21 mm;6)the distance between the internal carotid artery and point W was 4.95±0.26 mm;and 7)the vertical distance between the middle fossa floor and point W was 2.77±0.28 mm.Conclusion The location for cochlear fenestration on middle fossa floor(point W)is 10.71+0.63 mm from point O,which is the intersection of extensions of the arcuate eminence and greater superficial petrosal nerve.The angle between the line from point W to point O and the arcuate eminence was 81.40±3.40 degrees,and 38.45±2.46.3 degrees between the line and the superficial great petrosal nerve.