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目的:为迷路后进路处理桥脑小脑角区及内耳门区病变手术中内耳道的定位提供参考依据。方法:4%多聚甲醛固定的成人头颅标本(正常完整颅底)15例(30侧,性别不限),模拟迷路后进路操作,沿外半规管平面导入0°2.7 mm耳内镜,观察内耳道与外半规管的关系。结果:内耳道口中心与外半规管平面一致,面听神经束的走行(内耳道走行)与外半规管平面的关系:①面听神经起始部位于外半规管平面之下者2侧(6.7%);②面听神经起始部位于外半规管平面者15侧(50.0%);③面听神经起始部位于外半规管平面之上者13侧(43.3%)。结论:在迷路后进路桥脑小脑角区及内耳道手术中,以外半规管定位内耳道具有直接、准确、对周围组织损伤小的优点,更符合微创外科手术的要求。
OBJECTIVE: To provide a reference for the localization of the auditory canal in the process of treating the cerebellopontine angle in the traumatic brain and the lesion in the inner ear zone after labyrinthine approach. METHODS: Fifteen patients (normal or complete skull base) with 4% paraformaldehyde fixed adult skull base were enrolled in this study. Fifty patients (30 sides) were enrolled in the study. Road and the relationship between the semicircular regulatory. Results: The center of the inner auditory meatus was consistent with the plane of the lateral semicircular canal. The relationship between the walking of the auditory nerve tract (the running of the inner ear canal) and the plane of the lateral semicircular canal was as follows: ① The origin of the facial nerve was located on the 2 sides (6.7%) below the plane of the semicircular canal; The origin of the auditory nerve is located at 15 sides (50.0%) of the lateral semicircular canal plane; ③ The facial auditory nerve origin is located at 13 sides (43.3%) above the plane of the lateral semicircular canal. CONCLUSION: Posterior semicircular canal positioning in the cerebellopontine angle region and internal auditory canal surgery after labyrinthine incision has the advantages of direct and accurate, less damage to the surrounding tissue, more in line with the requirements of minimally invasive surgery.