CAJ | 학술논문

目的探讨乳突手术中面神经易损伤段的定位与辨认. 方法对我科2010年5月至2012年9月收治的97例乳突根治术或乳突根治术加鼓室成型术治疗的慢性化脓性中耳炎的病例进行回顾性分析,对手术中定位、辨认面神经易损伤段的方法进行总结. 结果 ①97例中发现1例面神经骨管的先天性缺损.②联合或者部分依靠外半规管隆突、砧骨短脚、匙突、鼓室天盖、镫骨作为解剖标志成功定位、辨认出面神经水平段97例.③依靠外半规管隆突和砧骨短脚或者单独依靠外半规管隆突作为解剖标志成功定位、辨认出面神经锥曲段97例.④联合或者部分依靠砧骨短脚、鼓索神经、锥隆起、外半规管隆突作为解剖标志成功定位、辨认出面神经垂直段近段97例. 结论面神经易损伤区内的外半规管隆突、砧骨短脚、匙突、鼓室天盖、镫骨、锥隆起、鼓索神经是乳突手术中确定面神经易损伤段的重要标志.
목적 탐토유돌수술중면신경역손상단적정위여변인. 방법 대아과2010년5월지2012년9월수치적97례유돌근치술혹유돌근치술가고실성형술치료적만성화농성중이염적병례진행회고성분석,대수술중정위、변인면신경역손상단적방법진행총결. 결과 ①97례중발현1례면신경골관적선천성결손.②연합혹자부분의고외반규관륭돌、침골단각、시돌、고실천개、등골작위해부표지성공정위、변인출면신경수평단97례.③의고외반규관륭돌화침골단각혹자단독의고외반규관륭돌작위해부표지성공정위、변인출면신경추곡단97례.④연합혹자부분의고침골단각、고색신경、추륭기、외반규관륭돌작위해부표지성공정위、변인출면신경수직단근단97례. 결론 면신경역손상구내적외반규관륭돌、침골단각、시돌、고실천개、등골、추륭기、고색신경시유돌수술중학정면신경역손상단적중요표지.
Objective To explore on location of the segments of the facial nerve being easy to damage in mastoid surgery.Methods Retrospective analysis was conducted according to the clinical data of 97cases with chronic suppurative otitis media performed with radical mastoidectomy (or radical mastoidectomy + tympanoplasty) from May 2010 to September 2012,and summarized the methods to locate the segment of the facial nerve being easy to damage in operation.Results ①One case of congenital defect of facial nerve canal was found in 97 cases.②The horizontal segments of the facial nerve of 97 cases were successfully located depending on combined/partial anatomic landmarks including eminence of the lateral semicircular canal,short limb of incus,cochlearform process,tympanic tegmen,stapes.③The pyramidal segment of facial nerve of 97 cases were successfully located depending on combined/partial anatomic landmarks including eminence of the lateral semicircular canal,short limb of incus.④The proximal part of vertical segment of the facial nerve of 97 cases were successfully located depending on combined /partial anatomic landmarks including short limb of incus,chorda tympani nerve,pyramidal eminence,eminence of the lateral semicircular canal.Conclusion The eminence of the lateral semicircular canal,short limb of incus,cochlearform process,tympanic tegmen,stapes,pyramidal eminence,chorda tympani nerve in the area in which the facial nerve being easy to damage are important landmarks by which the segment of facial nerve easy to damage might be located in mastoid surgery.