颅中窝硬膜外入路颞骨岩部及内听道的显微解剖研究

发布时间：2018-06-14 14:44

本文选题：颅中窝入路 + 颞骨岩部　；参考：《青岛大学》2006年硕士论文

【摘要】：【目的】观察测量颅中窝及颞骨岩部的骨性结构,为经颅中窝入路听神经瘤切除及面、听神经保留提供解剖依据。【方法】采用10例经福尔马林固定的成人头颅标本,经颈内动脉灌注红色乳胶。用头架将尸头固定在手术台上,取耳前颧弓根上垂直切口,长约7cm,以颧弓根为中心,做2×3cm骨窗,以咬骨钳将骨窗咬至颧弓根与颅底平行。显微镜下将脑膜抬起,暴露出岩浅大神经、面神经裂孔和弓状隆起。采取Fisch法暴露内听道,用磨钻磨除弓状隆起后外侧骨质,直至蓝线,其下为上半规管,然后以上半规管壶腹为中心向内侧做60°角,向内向下磨除骨质,直至暴露内听道顶壁。找到Bill嵴,辨认出面神经及前庭神经,磨除上壁骨质,于外侧壁处切开硬膜。在手术显微镜下解剖观察颞骨岩部及内耳道结构。术后去除脑组织,保留硬脑膜和颞骨岩部,进一步磨除颞骨岩部暴露耳蜗、前庭、膝状神经节等,用两脚规、游标卡尺、量角器等进行测量。【结果】上半规管大部分位于弓状隆起前下方,与弓状隆起距离在0～3.26mm之间。内耳道与上半规管形成约59.10±1.70°夹角。内耳道长度9.85±0.91mm,内耳道后壁厚度由内向外为7.82～3.86mm。 [结论] 在明确颞骨岩部解剖标志的基础上,颅中窝入路可以充分暴露内耳道远外侧端,是切除小型听神经瘤并保留面、听神经功能的有效方法。
[Abstract]:[objective] to observe and measure the bone structure of the middle cranial fossa and the petrosal part of the temporal bone. [methods] Ten adult head specimens fixed by formalin were perfused with red latex through internal carotid artery. The cadaver head was fixed on the operating table with the head frame, and the vertical incision on the root of the anterior ear zygomatic arch was taken, which was about 7 cm long. Taking the root of the zygomatic arch as the center, the bone window of 2 脳 3cm was made, and the bone window was bitten to the root of the zygomatic arch and parallel to the base of the skull with a rongeur forceps. The meninges are raised under a microscope to expose the superficial petrosal nerve, facial nerve hiatus, and arcuate eminence. Fisch method was used to expose the medial auditory canal, and the posterior lateral bone of arcuate protuberance was removed with grinding drill until the blue line, the lower canal was the upper semicircular canal, and the superior semicircular canal had 60 掳angle to the medial side for the center of the ampulla, and the bone was sharpened inward and downward until the parietal wall of the inner auditory canal was exposed. Identify the facial nerve and vestibular nerve, grind the upper wall bone, and cut the dura at the lateral wall. The petrosal part of the temporal bone and the structure of the internal auditory canal were dissected under the operation microscope. After operation, the brain tissue was removed, the dura mater and the petrosal part of the temporal bone were preserved, and the petrous part of the temporal bone was further ground to expose the cochlea, vestibule, geniculate ganglion, etc. [results] most of the superior semicircular canal was located below the arch protuberance and the distance from the arch to the arch was between 0~3.26mm. The angle between the inner ear canal and the superior semicircular canal was about 59.10 卤1.70 掳. The length of the internal auditory canal was 9.85 卤0.91mm, and the thickness of the posterior wall of the inner auditory canal was 7.82 ~ 3.86mm. [conclusion] on the basis of identifying the anatomic markers of the petrosal region of temporal bone, the middle cranial fossa approach can fully expose the distal end of the inner ear canal, and is an effective method for removing small acoustic neuroma and preserving the facial and acoustic nerve function.
【学位授予单位】：青岛大学
【学位级别】：硕士
【学位授予年份】：2006
【分类号】：R651.1;R322

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