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目的:为耳蜗植入术提供耳蜗鼓岬区底转骨螺旋板的解剖资料,同时寻找从鼓岬表面定位骨螺旋板的方法。方法:取成人颞骨标本15例(30侧),经乳突后鼓室进路,进入鼓室;在手术放大镜下对鼓岬区骨螺旋板走行、分段及毗邻结构进行观测。结果:①耳蜗底转骨螺旋板在鼓岬区可通过位于蜗窗龛上缘及下部的转折点分成3段:钩段(1.52±0.16)mm,蜗窗前下段(3.83±0.37)mm和前行段(2.70±0.36)mm;②蜗窗前下段所在平面与面神经水平段成角为(51.00±5.97)°,且较恒定地与镫骨头后缘相交;以镫骨头后缘为一固定点,在鼓岬上画一经过此点与面神经水平段成51°的直线,可代表骨螺旋板蜗窗前下段在鼓岬上的投影,也即此段骨螺旋板在鼓岬上的投影线;③鼓岬区鼓阶宽度:蜗窗龛上缘中点处宽度为(0.36±0.06)mm;蜗窗龛前缘中点处宽度为(0.97±0.14)mm;蜗窗前下3 mm处宽度为(1.24±0.21)mm。结论:①鼓岬区骨螺旋板可通过2个转折点分成3段,即钩段、蜗窗前下段和前行段;②骨螺旋板在鼓岬上的投影线及与毗邻结构的距离可以为人工耳蜗植入术中准确定位鼓阶,避免损伤基底膜提供形态学依据。
OBJECTIVE: To provide anatomical data for the cochlear promontory spiral osteotomy at the bottom of the cochlear implant, and to find a method of locating the bone spiral plate from the surface of the promontory. Methods: Fifteen cases (30 sides) of adult temporal bone specimens were entered into the tympanic space through the mastoid posterior tympanum. The walking, segmental and adjacent structures of the bone spiral plate in the promontory area were observed under a magnifying glass. Results: (1) The cochlear spiral plate of the bottom of the cochlea was divided into three sections by the turning point located in the upper edge and lower part of the snail niche: the hook segment (1.52 ± 0.16) mm, the anterior segment of the snail window (3.83 ± 0.37) mm and the anterior (2.70 ± 0.36) mm; (2) The plane between the anterior and inferior segment of the snail window and the horizontal plane of the facial nerve has an angle of (51.00 ± 5.97) °, which intersects with the trailing edge of the tarsal bone more invariably; the trailing edge of the tarsal bone is a fixed point , Draw a point on the promontory that passes through a point at 51 ° to the horizontal plane of the facial nerve to represent the projection of the anterior helical snail on the promontory of the promontory, ; (3) Drum cavern width in the promontory area: (0.36 ± 0.06) mm at the midpoint of the upper edge of the snail niche; (0.97 ± 0.14) mm at the midpoint of the leading edge of the snail niche; The width is (1.24 ± 0.21) mm. CONCLUSION: ① The promontory bone spiral plate can be divided into three sections by two turning points, namely the hook section, the anterior section of the snail window and the anterior section. ② The projection of the bone spiral plate on the promontory and the distance from the adjacent structure can be Cochlear implantation in the accurate positioning of the scala tympani, to avoid damage to the basement membrane to provide a morphological basis.