【摘要】：目的介紹一種新的耳內(nèi)鏡下經(jīng)耳道下入路人工耳蝸植入手術(shù)方式,探討各種植入方式的優(yōu)缺點。方法在3例甲醛固定的成人正常顳骨標(biāo)本開展新手術(shù)方式,并測量相關(guān)參數(shù)。結(jié)果所有標(biāo)本均在耳內(nèi)鏡下顯露圓窗龕,并植入電極,未開放乳突氣房和損傷鼓索神經(jīng)、面神經(jīng)。圓窗膜外側(cè)緣到鼓索神經(jīng)出骨性鼓環(huán)處距離(a)5.47±0.11mm;圓窗下緣到外耳道下壁6點電極骨槽骨性鼓環(huán)端距離(b)5.62±0.43mm;外耳道下壁長度(c)12.63±0.99mm;面神經(jīng)乳突段到外耳道下壁電極骨槽的最短距離(d)4.65±0.50mm;外耳道上壁長度(e)17.02±1.52mm。結(jié)論耳內(nèi)鏡下經(jīng)耳道下入路人工耳蝸植入術(shù)是一種微創(chuàng)、安全、快捷且容易學(xué)習(xí)的具有可行性的新手術(shù)方式,對顯微鏡下圓窗顯露不滿意等復(fù)雜病例更具有其優(yōu)勢,但其具體效果尚待臨床上進一步驗證,并且對于其存在的局限性和并發(fā)癥風(fēng)險等問題仍需進一步的研究改進。
[Abstract]:Objective to introduce a new endoscopic approach for cochlear implantation. Methods A new operative method was performed in 3 normal adult temporal bone specimens fixed with formaldehyde and the related parameters were measured. Results all specimens were exposed by endoscope and implanted with electrodes. The papillary chamber was not opened and the nerve of tympanic cord and facial nerve was injured. (a) 5.47 鹵0.11mm from the lateral edge of the round window membrane to the osseous ring of the chorda tympani nerve, (b) 5.62 鹵0.43mm from the lower edge of the round window to the inferior wall of the external auditory canal, (c) 12.63 鹵0.99mm from the length of the inferior wall of the external auditory meatus, and the most important distance from the mastoid segment of the facial nerve to the electrode bone groove of the inferior wall of the external auditory canal. The short distance (d) was 4.65 鹵0.50mm, the length of the superior wall of the external auditory canal was 17.02 鹵1.52mm. Conclusion Endoscopic transauricular cochlear implantation is a new operative method with minimally invasive, safe, fast and easy to learn. It is more advantageous to complicated cases, such as dissatisfactory exposure of round window under microscope. However, its specific effect needs to be further verified in clinic, and further research and improvement are needed for its limitation and complication risk.
【作者單位】： 佛山市第一人民醫(yī)院耳鼻咽喉頭頸外科;中國人民解放軍總醫(yī)院耳鼻咽喉頭頸外科;貴陽市第一人民醫(yī)院耳鼻咽喉科;
【分類號】：R322;R764.9

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1 王少植;夏寅;周兵;王政偉;賀飛;韓德民;;耳內(nèi)鏡下實驗解剖內(nèi)耳門區(qū)血管神經(jīng)[J];中國耳鼻咽喉頭頸外科;2008年03期

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