摘要
目的研究上鼓室前隐窝的应用解剖学结构。方法采用颞骨薄层CT扫描和颞骨解剖的方法对16对颞骨(其中成人12对,婴幼儿4对)的上鼓室前隐窝结构进行观察、测量。结果①上鼓室前隐窝的前后径(a)为4.26±1.36mm,垂直径(b)为4.78±1.17mm。儿童和成人上鼓室前隐窝大小无显著性差异(P>0.05)。成人上鼓室前隐窝大小和乳突气化程度无关(P>0.05)。其左右侧大小也无显著性差异(P>0.05)。②上鼓室前隐窝可分Ⅰ型和Ⅱ型:Ⅰ型26侧,其由鼓膜张肌皱襞隔成两个间隙;Ⅱ型6侧,其仅含一个间隙。鼓膜张肌皱襞中央缺如者在Ⅰ型中占57.69%(1526),在Ⅱ型中占66.67%(46)。上鼓室前隐窝的大小与乳突气化类型无关(P>0.05)。③匙突是耳科手术的重要解剖标志,膝状神经节至匙突的距离经测量为2.79±0.39mm。面神经水平段至匙突的距离经测量为0.89±0.33mm。结论熟悉上鼓室前隐窝的解剖特征及其重要内容如膝状神经节、匙突、面神经水平段之间的关系至关重要。术中必要时应充分暴露该区域以彻底去除病灶并改善其通气引流,但应避免损伤面神经。
Objective To investigate the surgical anatomy of the anterior epitympanie recess （AER）. Methods 16 pairs of human temporal bones including 12 pairs of adults and 4 pairs of children were studied by high resolution CT measurements and temporal bone dissection. Results ①There was no significant difference in size of the AER between children and adults （ P 〉 0. 05）. There was no relationship between the size of the AER and pnetunatization of mastoid cells in adults （ P 〉 0.05）. The size of the AER showed no difference between left and right （ P 〉 0.05 ）. ②The AER was classified into two types according to its shape and structure ： type Ⅰ including 26 specimens with two cavities separated by tensor tympanic fold and type Ⅱ including 6 specimens with only one cavity. The tensor tympanic folds had membrance defect in 15/26 of type Ⅰ and 4/6 of type Ⅱ. There was no significant difference in size of the AER between type Ⅰand type Ⅱ （P 〉 0.05）. ③The cochleariform process was an important landmark in middle ear surgery. The distance between the cochleariform process and geniculate ganglion was 2.79 ± 0.39 mm. The distance between the cochleariform process and tympanic portion of facial nerve was 0.89 ± 0.33 mm. Conclusion It is important for otologists to know the anatomic structure of AER and its relationship with facial nerve and geniculate ganglion. Surgical exploration of this area is proposed for improving ventilation of the attic without injurying facial nerve.
出处
《听力学及言语疾病杂志》
CAS
CSCD
2005年第5期304-306,i0001,共4页
Journal of Audiology and Speech Pathology
关键词
上鼓室前隐窝
匙突
膝状神经节
面神经
鼓膜张肌皱襞
齿突
Anterior epitympanic recess（AER）
Cochleariform process
Geniculate ganglion
Facial nerve
Tensot tympanic fold
Cog
作者简介
陈斌，男，上海人，副主任医师，博士研究生，主要从事听力学与前庭功能研究。
