耳蜗导水管显微解剖与多层螺旋CT影像学研究

Study of microsurgical anatomy and multi-slice helical CT scanning of cochlear aqueduct

目的 为迷路进路中所遇到的耳蜗导水管及其周围的结构提供显微解剖学及CT影像学依据。方法 选用 2 0具甲醛固定的成人尸头 (共 4 0侧 )进行耳蜗导水管的显微解剖及测量 ,并对 5具(10侧 )成人尸头进行多层螺旋CT扫描。结果 耳蜗导水管外口宽度为 2 6 4± 0 82mm ,长度为 8 4 0± 1 35mm ,耳蜗导水管外口到内听道下唇的距离为 5 5 3± 0 93mm ,外口至Ⅸ、Ⅹ、Ⅺ脑神经距离为1 0 8±0 36、2 71± 0 6 3和 4 5 2± 1 2 5mm。耳蜗导水管外口至岩下窦为 1.14± 0 .4 6mm。螺旋CT冠状位扫描只能显示耳蜗导水管的岩骨段 ,轴位扫描对耳蜗导水管的岩骨段及听囊段均能显示。结论 对于耳蜗导水管CT轴位扫描较好 ;在迷路进路手术中 ,耳蜗导水管可作为一避免伤及其他重要结构的标志。

Objective To obtain more detailed microsurgical anatomical data and multi-slice helical CT scanning of cochlear aqueduct for the translabyrithine approach. Methods Twenty cadaver heads(40 sides)fixed with formalin were dissected under a microscope ,and cochlear aqueducts were found and measured. Five cadaver heads(10 sides) were scanned by multi-slice helical CT. Results The width of external aperture of cochlear aqueduct was (2.64±0.82)mm. The length of cochlear aqueduct was (8.40±1.35)mm. The distance between cochlear aqueduct and cranial nerves Ⅸ, Ⅹ, Ⅺ, and that between the inferior petrosal sinus was(1.08±0.36 )mm,(2.71±0.63)mm,(4.52±1.25)mm, (1.14±0.46)mm, respectively. The distance between external aperture of cochlear aqueduct and the inferior margin of internal acoustic meatus aperture was (5.53±0.93)mm. The otic capsule segment of cochlear aqueduct could not be demonstrated on the coronal section. The petrosal portion could be demonstrated by both coronal and axial scannings. Conclusion The axial scanning was useful for detecting cochlear aqueduct. Cochlear aqueduct could be regarded as one of the landmarks in translabyrithine approach for cerebellopontile angle operation.