CAJ | 학술논문

目的：探讨经乳突面隐窝入路后鼓室人路的相关解剖，进行观察测量，为该入路手术提供解剖学资料。方法成人头颅福尔马林泡过6例12侧，在放大10倍的手术显微镜下模拟中耳乳突面隐窝后鼓室入路手术，观察和测量了外耳道上棘、面神经、面隐窝、锥隆起、圆窗、卵圆窗，岬小桥、岬后脚、等相关的解剖结构，数据进行统计学处理。结果外耳道上棘至砧骨短脚的平均距离为20.06mm，外耳道上棘至面神经锥段中点平均距离为17.28 mm，面神经锥段中点距外耳道后壁垂直距离平均为4.67mm，面神经水平段平均长12.30 mm，面神经垂直段平均长16.31 mm．面神经水平段与垂直段的夹角平均为111.5°，鼓索神经与面神经垂直段的夹角平均为23.9°锥隆起至圆窗龛的平均距离为4.46 mrn，锥隆起到镫骨头平均距离2.62mm，锥隆起到砧骨窝平均距离4.43mm，卵圆窗至圆窗龛的平均距离为3．84 mm，砧镫关节至圆窗龛的平均距离为3．89mm面神经锥段中点到卵圆窗平均距离8.10mm；面神经锥段中点到岬小桥与岬下脚下端的距离分别是(4.85±0.45mm),(6.21±0.52mm)；鼓索神经和面神经垂直段夹角平均为48.3°，水平半规管与面神经水平段夹角平均为19.5°，面神经水平段与垂直段夹角平均为111.5°。结论中耳乳突入路手术中部分重要解剖结构位置恒定，重要解剖结构间距离及角度在一定范围内变化，熟悉其解剖关系，可以完全的清楚病变，又可以指导临床手术，避免手术损伤。
목적：탐토경유돌면은와입로후고실인로적상관해부，진행관찰측량，위해입로수술제공해부학자료。방법성인두로복이마림포과6례12측，재방대10배적수술현미경하모의중이유돌면은와후고실입로수술，관찰화측량료외이도상극、면신경、면은와、추륭기、원창、란원창，갑소교、갑후각、등상관적해부결구，수거진행통계학처리。결과외이도상극지침골단각적평균거리위20.06mm，외이도상극지면신경추단중점평균거리위17.28 mm，면신경추단중점거외이도후벽수직거리평균위4.67mm，면신경수평단평균장12.30 mm，면신경수직단평균장16.31 mm．면신경수평단여수직단적협각평균위111.5°，고색신경여면신경수직단적협각평균위23.9°추륭기지원창감적평균거리위4.46 mrn，추륭기도등골두평균거리2.62mm，추륭기도침골와평균거리4.43mm，란원창지원창감적평균거리위3．84 mm，침등관절지원창감적평균거리위3．89mm면신경추단중점도란원창평균거리8.10mm；면신경추단중점도갑소교여갑하각하단적거리분별시(4.85±0.45mm),(6.21±0.52mm)；고색신경화면신경수직단협각평균위48.3°，수평반규관여면신경수평단협각평균위19.5°，면신경수평단여수직단협각평균위111.5°。결론중이유돌입로수술중부분중요해부결구위치항정，중요해부결구간거리급각도재일정범위내변화，숙실기해부관계，가이완전적청초병변，우가이지도림상수술，피면수술손상。
Objective To provide the anatomic data for operation on the posterior tympanum through the transmastoid fa-cial recess approach and measurement of related anatomic structure.Method 12 sides of 6 temporals had their mastoids out-lined and removing the latend wall of external auditory canal by an electric drill, and then the related structure of the posterior tympanum was exposed under surgical micmscope. Observation and Measurement of the suprameatal spine, facial nerve, fa-cial recess, pyramidal eminence, round window, oval window measured, ponticulus, pseudosubiculum andother related ana-tomical structure, statistical datas which were statistically analyzed. Result The average distances from auprameatal spine to short crus incus, The midpoint of pyramid segment of facial nerve canal were 20.06mm, 17.28 mm, respectively.The average distances from the midpoint of pyramid segment of facial canal to the posterior wall of external auditory canal was 4.67mm;The average length of facial nerve in the horizonial segment, the perpendicular paragraph was about 12.30mm,16.31mm,re-spectively. The average distance from pyramidal eminence to the anterior lip of round window niche,from oval window to round window niche,from incudostapedial joint to round window niche was 4.46 mm, 3.84mm, 3.89 mm, espectively. The aver-age distancs from the midpointof pyramid segment of facial canal to the lower endof the ponticulus, the lower end of the pseu-dosubiculum were 4.85mm, and 6.21mm respectively. chorda tympani nerve with facial nerve in the perpendicular paragraph was 48.3°,horizontal semicircular canal and facial nerve in the level paragraph was110.5°. Conclusion The position of ana-tomic structure in middle ear was constant and the relationship including distance and angle between anatomic structures changed in limited region.The anatomical parameters provide a reference value for avoiding the injury during the operation.