本文選題：顱中窩入路 + 顳骨巖部　； 參考：《青島大學(xué)》2006年碩士論文

【摘要】：【目的】 觀察測(cè)量顱中窩及顳骨巖部的骨性結(jié)構(gòu),為經(jīng)顱中窩入路聽神經(jīng)瘤切除及面、聽神經(jīng)保留提供解剖依據(jù)。 【方法】 采用10例經(jīng)福爾馬林固定的成人頭顱標(biāo)本,經(jīng)頸內(nèi)動(dòng)脈灌注紅色乳膠。用頭架將尸頭固定在手術(shù)臺(tái)上,取耳前顴弓根上垂直切口,長(zhǎng)約7cm,以顴弓根為中心,做2×3cm骨窗,以咬骨鉗將骨窗咬至顴弓根與顱底平行。顯微鏡下將腦膜抬起,暴露出巖淺大神經(jīng)、面神經(jīng)裂孔和弓狀隆起。采取Fisch法暴露內(nèi)聽道,用磨鉆磨除弓狀隆起后外側(cè)骨質(zhì),直至藍(lán)線,其下為上半規(guī)管,然后以上半規(guī)管壺腹為中心向內(nèi)側(cè)做60°角,向內(nèi)向下磨除骨質(zhì),直至暴露內(nèi)聽道頂壁。找到Bill嵴,辨認(rèn)出面神經(jīng)及前庭神經(jīng),磨除上壁骨質(zhì),于外側(cè)壁處切開硬膜。在手術(shù)顯微鏡下解剖觀察顳骨巖部及內(nèi)耳道結(jié)構(gòu)。術(shù)后去除腦組織,保留硬腦膜和顳骨巖部,進(jìn)一步磨除顳骨巖部暴露耳蝸、前庭、膝狀神經(jīng)節(jié)等,用兩腳規(guī)、游標(biāo)卡尺、量角器等進(jìn)行測(cè)量。 【結(jié)果】 上半規(guī)管大部分位于弓狀隆起前下方,與弓狀隆起距離在0～3.26mm之間。內(nèi)耳道與上半規(guī)管形成約59.10±1.70°夾角。內(nèi)耳道長(zhǎng)度9.85±0.91mm,內(nèi)耳道后壁厚度由內(nèi)向外為7.82～3.86mm。 [結(jié)論] 在明確顳骨巖部解剖標(biāo)志的基礎(chǔ)上,顱中窩入路可以充分暴露內(nèi)耳道遠(yuǎn)外側(cè)端,是切除小型聽神經(jīng)瘤并保留面、聽神經(jīng)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 擄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 鹵1.70 擄. The length of the internal auditory canal was 9.85 鹵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.
【學(xué)位授予單位】：青島大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2006
【分類號(hào)】：R651.1;R322

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本文編號(hào)：2017749