面神经垂直段及其周围结构的临床应用解剖

发布时间：2018-05-15 04:27

本文选题：面神经 + 解剖　；参考：《中华耳科学杂志》2014年03期

【摘要】：目的探讨颞骨手术中面神经垂直段的走行特点及其定位方法。方法应用30例(60侧)成人尸头标本,(其中3例新鲜标本,27例10%福尔马林固定标本)。在手术显微镜下模拟乳突部位手术,暴露面神经垂直段及其周围结构,观察面神经垂直段的走行特点,与周围结构的关系以及面神经管周围的骨质变化特点。结果面神经垂直段长度(16.31±1.29)mm,面神经垂直段至后半规管距离(2.65±0.85)mm,面神经垂直段至骨性外耳道口距离(17.28±1.09)mm,面神经垂直段至颈静脉球距离(3.58±1.32)mm,面神经垂直段至外耳道后壁距离(4.67±0.39)mm,面神经垂直段至乙状窦距离(6.42±2.65)mm.面神经隐窝外侧气房存在者88.33%,面神经隐窝外侧气房位于面神经管外0~2mm.接近面神经管部位血运丰富,为营养面神经的微血管所在.锥隆起在面神经管稍靠内侧,附着在面神经管内1/3以内位置,面神经垂直段位于二腹肌嵴的前端并稍靠内。鼓乳裂消失就接近面神经垂直段。结论面神经隐窝外侧气房、锥隆起、二腹肌嵴、鼓乳裂等,能够帮助我们定位面神经垂直段。解剖学实践、体会面神经垂直段与接近面神经过程中骨质的改变、颜色改变,才能更准确地定位面神经。
[Abstract]:Objective to investigate the characteristics and localization of the vertical segment of facial nerve in temporal bone surgery. Methods 30 adult cadaveric head specimens (including 3 fresh specimens, 27 cases with 10% formalin fixation) were used. The vertical segment of the facial nerve and its surrounding structure were exposed under the operating microscope. The characteristics of the vertical segment of the facial nerve and the relationship between the vertical segment of the facial nerve and the surrounding structure as well as the bone changes around the facial nerve canal were observed. Results the length of the vertical segment of the facial nerve was 16.31 卤1.29 mm, the distance between the vertical segment of the facial nerve and the posterior semicircular canal was 2.65 卤0.85 mm, the distance between the vertical segment of the facial nerve and the orifice of the osseous external auditory canal was 17.28 卤1.09 mm, the distance between the vertical segment of the facial nerve and the jugular vein ball was 3.58 卤1.32 mm, and the distance between the vertical segment of the facial nerve and the posterior wall of the external auditory canal was 4.67 卤0.39 mm. The distance from vertical segment of facial nerve to sigmoid sinus was 6.42 卤2.65 mm. The lateral chamber of the facial recess was 88.33 mm, and the lateral chamber of the recess of the facial nerve was 0 ~ 2 mm outside the facial nerve canal. Near the facial canal, the blood flow is abundant, which is the microvessel of the nutritive facial nerve. The conical eminence is located slightly on the medial side of the facial canal and within a third of the facial canal. The vertical segment of the facial nerve is located at the front and slightly inside of the bicentric crest. The cleavage of tympanum is close to the vertical segment of the facial nerve. Conclusion the lateral chamber of the facial recess, conical eminence, bicentric ridge, tympanic and mammary fissure can help us locate the vertical segment of the facial nerve. In order to locate the facial nerve more accurately, the changes of bone and color in the vertical segment of the facial nerve and the approach to the facial nerve can be realized in anatomical practice.
【作者单位】：南方医科大学第三附属医院耳鼻咽喉头颈外科;
【基金】：广东省自然科学基金项目项目编号A2010350 南方医科大学第三附属医院院长基金项目项目编号A200901
【分类号】：R651.3;R322

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