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目的 探讨面神经颅内段的显微解剖 ,为临床手术提供解剖学参数。方法 应用 1 0 %甲醛充分固定的成人尸头标本 1 0例 2 0侧 ;漂白干颅骨 1 0例 2 0侧。结合侧方手术入路对面神经及其毗邻结构进行测量和拍照。结果 面神经颅内段分为五段 ,即脑桥小脑角段、内耳道段、迷路段、鼓室段和乳突段。脑桥小脑角段和内耳道段与位听神经伴行 ;迷路段最短最细 ,约 3.8mm± 0 .7mm长 ;鼓室段与骨迷路和中耳关系密切 ;乳突段长约 1 5.5mm± 1 .9mm ,经茎乳孔出颅。结论 枕下乙状窦后入路中可利用第四脑室脉络丛定位面神经脑干端 ;经岩前入路中可利用弓状隆起和岩浅大神经定位面神经内耳道段和迷路段 ;部分鼓室段骨壁缺如 ,面神经直接裸露在岩骨表面 ;外半规管至二腹肌嵴前端是面神经乳突段的标志线。
Objective To investigate the microsurgical anatomy of intracranial facial nerve and provide anatomic parameters for clinical operation. Methods 10 cases of adult cadaver heads with 10% formalin fixed on 20 sides and 10 cases of bleached dry skulls on 20 sides. Combined with lateral approach to the facial nerve and its adjacent structures were measured and photographed. Results Facial nerve intracranial segment is divided into five sections, namely, the cerebellopontine angle segment, the inner ear segment, the lost segment, the tympanic segment and the mastoid segment. The cerebellopontine angle segment and the auditory canal of the inner ear segment are accompanied by the auditory nerve; the shortest and the shortest segment of the lost segment is about 3.8mm ± 0.7mm in length; the tympanic segment is closely related to the bony labyrinth and the middle ear; the mastoid segment is about 1 5.5mm ± 1 .9 mm, the skull through the skull. Conclusions The posterior suboccipital sigmoid sinus posterior approach can utilize the fourth ventricle choroid plexus located at the brainstem of the facial nerve. By means of anterior petrous apexes and arcuate maxillary nerves, Absence of bone wall, the facial nerve directly exposed on the surface of the rock; external semicircular canal to the front of the dyndymic crest is a marker line facial papillae.