CAJ | 학술논문

目的通过对前庭窗下缘与耳蜗底转骨内膜间毗邻关系的解剖测量,探索困难镫骨手术中前庭窗下方鼓岬磨钻、开窗的安全范围.方法 14个成人颞骨标本,采用组织学切片的方法,在前庭窗下缘前、中、后的三个垂直切面上对前庭窗下缘与耳蜗底转骨内膜不同部位间的距离、骨内膜高度及对应的鼓岬厚度进行测量.结果前庭窗后端下方鼓岬最厚,平均约1.1 mm,该处耳蜗骨内膜最深在,平均高度仅约0.2 mm,但该处前庭窗下缘距离下方耳蜗骨内膜仅0.3 mm.结论磨除鼓岬部分骨质的相对安全部位是前庭窗后端下方,磨钻方向须保持向外下.
목적 통과대전정창하연여이와저전골내막간비린관계적해부측량,탐색곤난등골수술중전정창하방고갑마찬、개창적안전범위.방법 14개성인섭골표본,채용조직학절편적방법,재전정창하연전、중、후적삼개수직절면상대전정창하연여이와저전골내막불동부위간적거리、골내막고도급대응적고갑후도진행측량.결과 전정창후단하방고갑최후,평균약1.1 mm,해처이와골내막최심재,평균고도부약0.2 mm,단해처전정창하연거리하방이와골내막부0.3 mm.결론 마제고갑부분골질적상대안전부위시전정창후단하방,마찬방향수보지향외하.
Objective To investigate the safety range of drilling and fenestration on promontory inferior to the oval window in difficult stapedectomy via anatomical study of the relationship between the inferior margin of oval window and the endosteum of basal cochlear turn.Methods By means of histological sections,the distances between the inferior margin of oval window and different locations of endosteum of basal cochlear turn,the corresponding height of the projecting endosteum and the thickness of promontory bone,on three vertical sections through the anterior,posterior and midpoint of the inferior edge of oval window were measured respectively.Results The promontory bone inferior to the posterior point of the oval window was thickest,with an average thickness of about 1.1 mm.The endosteum of basal turn at this portion was lowest,with an average height of O.2 mm.Furthermore,the shortest distance here between the inferior edge of oval window and the endosteum could be no more than 0.3 mm.Conclusion Relatively safe location of drilling on promontory should be selected on promontory inferior to the posterior point of the oval window,with the direction of drilling outward and downward.