改良迷路下进路开放内听道的应用解剖研究

发布时间：2018-01-13 01:02

本文关键词：改良迷路下进路开放内听道的应用解剖研究　出处：《昆明医学院》2006年硕士论文　论文类型：学位论文

【摘要】：目的：探讨切除后半规管的改良迷路下进路，开放内听道的术式，进行解剖学研究和数据测量，为此进路进行内听道手术提供解剖学标志、参数及依据，并探讨该方法的优越性及安全性。方法：用10％甲醛固定的20具(40侧耳)成人尸头，显微镜下(×6～16)模拟改良迷路下进路进行解剖，暴露内听道。观察乳突导血管的情况。测量乙状窦中段的宽度、乙状窦中段前缘到面神经垂直段的最短距离、颈静脉球的高度、颈静脉球顶到内听道下缘距离、颈静脉球顶到内听道上缘距离、水平半规管曲部后缘到后颅窝硬脑膜的距离、内听道口上下径高度和内听道的长度。对每一个测量结果均重复测量三次，取其平均值。所得数据用SPSS11.5或PEMS软件包统计分析。结果：乳突导血管的出现率为80％(32／40)，68.75％(22／32)的乳突导血管外口位于枕乳缝之前。乙状窦中段的宽度：(10.63±1.91)mm；乙状窦中段前缘到面神经垂直段的最短距离：(9.84±2.48)mm；颈静脉球的高度：(5.40±1.48)mm；颈静脉球顶到内听道下缘的距离：(3.03±1.93)mm；颈静脉球顶到内听道上缘的距离：(8.24±2.36)mm；水平半规管曲部后缘距后颅窝硬脑膜的距离：(5.60±1.28)mm；内听道口上下径高度：(4.13±0.85)mm；内听道后壁全长：(8.74±1.31)mm；内听道暴露长度(33侧可经改良迷路下进路暴露的内听道)：(5.45±1.04)mm，占全长的(61.52±10.00)％；切除后半规管弓，术中骨窗视野可达(5.60±1.28)mm×(8.24±2.36)mm。颈静脉球的高度与颈静脉球顶到内听道下缘的最短距离呈负相关(r=—0.742，P＜0.01)。结论： 1．改良迷路下进路开放内听道可明显扩大骨窗视野。 2．颈静脉球的高度与其顶到内听道下缘的距离呈负相关，，改良迷路下进
[Abstract]:Objective: to study the anatomical study and data measurement of modified labyrinthine sublabyrinthine approach with posterior semicircular canal resection, open internal auditory canal, and provide anatomic markers, parameters and basis for internal auditory canal operation. The superiority and safety of this method are discussed. Methods: 20 adult cadaveric heads fixed with 10% formaldehyde were dissected by the modified sublabyrinthine approach under microscope (脳 6 ~ (16)). The width of the middle part of sigmoid sinus, the shortest distance from the anterior edge of the sigmoid sinus to the vertical segment of the facial nerve, the height of the jugular bulb and the distance from the top of the jugular bulb to the inferior edge of the internal auditory canal were measured. The distance from the top of the jugular bulb to the superior edge of the auditory canal, the distance from the posterior edge of the horizontal semicircular canal to the dura mater of the posterior cranial fossa, the height of the superior and inferior diameter of the auditory orifice and the length of the internal auditory canal. The data were analyzed by SPSS11.5 or PEMS software package. Results: the occurrence rate of mastoid conduction vessels was 80 / 32 / 40). The external orifice of mastoid conduction vessel was located in front of occipital-mammary suture. The width of middle part of sigmoid sinus was 10.63 卤1.91 mm. The shortest distance from the anterior edge of the sigmoid sinus to the vertical segment of the facial nerve was 9.84 卤2.48 mm. The height of jugular bulb was 5.40 卤1.48 mm; The distance from the top of the jugular bulb to the inferior edge of the internal auditory canal was 3.03 卤1.93 mm; The distance from the top of the jugular bulb to the superior edge of the internal auditory canal was 8.24 卤2.36 mm. The distance between the posterior margin of horizontal semicircular canal and the dura mater of posterior cranial fossa was 5.60 卤1.28 mm. The height of the upper and lower diameter of the internal auditory entrance was 4.13 卤0.85 mm; The posterior wall of the internal auditory canal was 8.74 卤1.31 mm in length. The exposure length of the internal auditory canal was 5.45 卤1.04mm in 33 sides of the internal auditory canal exposed through the modified inferior labyrinthine approach, accounting for 61.52 卤10.00 mm of the total length. Resection of posterior semicircular canal arch. The visual field of bone window was 5.60 卤1.28mm 脳 8.24 卤2.36mmm. the height of jugular bulb was negatively correlated with the shortest distance from the top of jugular bulb to the inferior edge of internal auditory canal. R-0.742. P < 0.01. Conclusion: 1. The improved sublabyrinthine approach to open the internal auditory canal can significantly enlarge the visual field of bone window. 2. The height of jugular bulb was negatively correlated with the distance from the top to the inferior edge of the internal auditory canal, and the inferior labyrinthine approach was improved.
【学位授予单位】：昆明医学院
【学位级别】：硕士
【学位授予年份】：2006
【分类号】：R764;R322

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