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  本文關鍵詞： 顳骨 面神經(jīng) 斷層解剖學 冠狀面 火棉膠 HRCT　出處：《南昌大學》2007年碩士論文　論文類型：學位論文

【摘要】： 目的:觀測顳骨內(nèi)面神經(jīng)各段及鄰近結構在耳的冠狀薄層斷層標本和HRCT (high-resolution computed tomography,HRCT)冠狀掃描圖像上的形態(tài)特點及毗鄰關系,探討其在耳-頭頸外科手術中的臨床意義,為耳顳區(qū)病變的影像診斷和手術治療提供解剖學依據(jù)和形態(tài)學基礎。 方法:10%甲醛固定的成人顱腦標本15例(30側),以與眥耳線(canthomeatal line, CML)相垂直的定位線為基線,用GE Hispeed N X/ i Sys # CT掃描,獲得間隔為1.00 mm,厚度為1.00 mm的HRCT掃描圖像,用立體定位儀作出與HRCT掃描層面一致的標記。開顱取腦后,截取8 cm×8 cm×10 cm的組織塊,脫鈣、脫水、火棉膠浸膠、包埋并切制成厚為1.00 mm的連續(xù)冠狀薄層切片。HRCT掃描圖像和冠狀薄層切片上逐一對面神經(jīng)各段及鄰近約45個與臨床手術相關的重要結構進行定位與測量,經(jīng)統(tǒng)計學處理得出結論。 結果:經(jīng)膝狀神經(jīng)節(jié)(geniculate ganglion, GG)后2/3層面:GG至鼓室蓋上緣垂直距離為(2.43±0.79) mm(右x±smm下同);GG至咽鼓管上壁距離為(6.09±0.93) mm。經(jīng)錘骨頭中部層面:面神經(jīng)水平段(horizontal facial nerve, HFN)距盾板尖距離為(4.09±0.58) mm;HFN距耳蝸最短距離為(1.37±0.27) mm;錘骨頭距鼓室蓋上壁垂直距離為(2.23±0.13) mm;HFN距錘骨頭內(nèi)側最短距離為(3.30±0.08) mm。經(jīng)匙突中部層面:面神經(jīng)迷路段(labyrinthine facial nerve,LFN)距耳蝸最短距離為(0.59±0.13) mm; HFN距鼓室盾板尖距離為(5.13±0.59) mm;匙突距錘骨頭下緣距離為(2.9±40.34) mm;匙突距耳蝸第二轉距離為(1.99±0.69) mm。經(jīng)砧鐙關節(jié)層面:HFN至卵圓窗(oval window, OW)外壁距離為(1.78±0.17) mm;HFN至鐙骨底板距離為(2.44±0.60) mm;HFN至砧骨短腳距離為(2.89±0.52) mm;經(jīng)圓窗龕(round window niche, RWN)層面:HFN至鼓索神經(jīng)距離為(2.54±0.44) mm;面神經(jīng)隱窩(facial recess, FR)深度平均值為(1.82±0.87) mm;FR橫徑平均值為(2.70±0.73) mm;RWN橫徑平均值為(1.67±0.23) mm;RWN深度平均值為(1.36±0.42) mm;錐隱窩平均深度為(2.65±0.58) mm;經(jīng)面神經(jīng)垂直段層面:面神經(jīng)垂直段(vertical facial nerve, VFN)距后半規(guī)管(posterior semicircular canal, PSC)距離為(2.50±0.33) mm;VFN至鼓索神經(jīng)(chorda tympani nerve, CTN)距離為(2.47±0.19) mm;莖乳孔至CTN分叉處的距離為(5.23±0.53)mm;VFN長度平均值為(14.20±1.30) mm;VFN橫徑平均值為(1.41±0.30) mm。 結論:顳骨HRCT冠狀掃描圖像結合顳骨火棉膠冠狀薄層斷層標本,能良好顯示顳骨內(nèi)面神經(jīng)各段及鄰近諸解剖結構的毗鄰關系。這種對照研究能直觀準確地辨認顳骨內(nèi)諸解剖結構并找出面神經(jīng)及鄰近結構在HRCT圖像上的分布規(guī)律和定位依據(jù),為耳顳區(qū)的醫(yī)學影像學診斷和顱腦-頭頸外科手術治療提供解剖學依據(jù)和形態(tài)學基礎。
[Abstract]:Objective: to observe the coronal thin sectional specimens and HRCT of the segments and adjacent structures of the temporal facial nerve in the ear. High-resolution computed tomography. To explore the clinical significance of HRCT coronal scan in otolhead and neck surgery. To provide anatomical basis and morphological basis for imaging diagnosis and surgical treatment of auricular and temporal lesions. Methods Fifteen adult craniocerebral specimens fixed with 10% formaldehyde were collected from 30 sides of the craniocerebral specimens. The localization line perpendicular to the canthus auricular line (CML) was used as the baseline. GE Hispeed N X / I Sys # CT scan was used to obtain HRCT scanning images with an interval of 1.00 mm and a thickness of 1.00 mm. After craniotomy, the tissue mass of 8 cm 脳 8 cm 脳 10 cm was cut off, decalcified, dehydrated, and colloid soaked. Bury and cut to make 1.00 thick. Mm continuous coronal thin-layer section. HRCT scanning image and coronal thin-layer slice were used to locate and measure each segment of facial nerve and its adjacent 45 important structures related to clinical operation. The conclusion is obtained by statistical analysis. Results: geniculate ganglion was transgeniculate through geniculate ganglion. The vertical distance from 2/3: GG to the superior margin of tympanic lid was 2.43 鹵0.79mm (right x 鹵smm). The distance from GG to the superior wall of the eustachian tube was 6.09 鹵0.93mm. the medial level of the malleable bone was the horizontal segment of the facial nerve, and the horizontal segment of the facial nerve was facial nerve. The distance from HFN to shield tip was 4.09 鹵0.58 mm; The shortest distance from HFN to cochlea was 1.37 鹵0.27 mm. The vertical distance between the mallet bone and the superior wall of the tympanic cover was 2.23 鹵0.13 mm. The shortest distance from HFN to the medial part of the mallet bone was 3.30 鹵0.08 mm. The midway of the spassus was labyrinthine facial nerve. The shortest distance from LFN to cochlea was 0.59 鹵0.13 mm. The distance from HFN to the tip of tympanic shield plate was 5.13 鹵0.59 mm; The distance between the spassum process and the lower margin of the malleus bone was 2.9 鹵40.34 mm. The distance from the second turn of the spassum to the cochlea was 1.99 鹵0.69 mm. The oval window was reached from the stirrup joint plane to the oval window. The distance of outer wall of owl was 1.78 鹵0.17 mm; The distance between HFN and stapes was 2.44 鹵0.60 mm. The distance from HFN to the short foot of the incus was 2.89 鹵0.52 mm. The distance between window and chorda tympani nerve was 2.54 鹵0.44 mm in the round window niche (RWN). The average depth of facial recess (FR) was 1.82 鹵0.87 mm. The mean transverse diameter of FR was 2.70 鹵0.73 mm; The average transverse diameter of RWN was 1.67 鹵0.23 mm; The average depth of RWN was 1.36 鹵0.42mm; The mean depth of cone recess was 2.65 鹵0.58 mm. Vertical facial nerve of facial nerve. The distance from posterior semicircular canal to posterior semicircular was 2.50 鹵0.33 mm. The distance between VFN and chorda tympani was 2.47 鹵0.19 mm. The distance from the stem mammary foramen to the CTN bifurcation was 5.23 鹵0.53mm. The average length of VFN was 14.20 鹵1.30 mm; The average transverse diameter of VFN was 1.41 鹵0.30 mm. Conclusion: HRCT coronal scan of temporal bone combined with coronal slice specimens of the temporal bone. The comparative study can identify the anatomical structures in temporal bone and find out the difference of facial nerve and its adjacent structures on HRCT images. The rule of distribution and the basis of location. To provide anatomical basis and morphological basis for medical imaging diagnosis and craniocerebral-head-neck surgical treatment of ear-temporal region.
【學位授予單位】：南昌大學
【學位級別】：碩士
【學位授予年份】：2007
【分類號】：R322

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