The effect of hyalinized chorda tympani nerve canal in protection of mastoid segment of facial nerve in middle ear surgery
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摘要: 目的:通过观察胆脂瘤型中耳炎手术中透明化鼓索神经和透明化面神经垂直段和面神经嵴的位置关系,探讨在该手术中透明化鼓索神经是否具有定位面神经垂直段和面神经嵴高度的作用。方法:2008-2010年我科收治的118例胆脂瘤型中耳炎患者行开放式鼓室成形术,手术中结合采用根据水平半规管、砧骨窝的位置和透明化鼓索神经的方法定位面神经垂直段和面神经嵴的高度。结果:99例面神经嵴磨至鼓索神经乳突段平面,面神经垂直段未显露;9例面神经垂直段透明显露,低于鼓索神经乳突段1~2 mm,前后方向2~3 mm,位置恒定;9例患者听骨链、砧骨窝、水平半规管和面神经骨管有不同程度的破坏,面神经垂直段低于鼓索神经乳突段1~2 mm,前后方向2~3 mm;1例面神经垂直段透明显露,高于鼓索神经乳突段。结论:透明化鼓索神经乳突段在胆脂瘤型中耳炎手术中可作为定位面神经垂直段和磨低面神经嵴的标志,是对传统方法定位面神经垂直段的补充,特别对于传统定位面神经标志破坏者,定位面神经的意义尤为明显。Abstract: Objective: To investigate the effect of hyalinized chorda tympani nerve canal in mastoid segment to landmark facial nerve in middle ear surgery by means of observing the location relationship between hyalinized chorda tympani nerve canal and facial nerve.Method: 118 cases of cholesteatoma otitis media in our hospital undergoing tympanoplasty from 2008 to 2011 were retrospectively analyzed. In all the cases, the position of horizontal semicircular and fossa incus as well as the hyalinized chorda tympani nerve canal were used for landmark the height of facial ridge and vertical segment of facial nerve.Result: The chorda tympani nerve of 99 patients were higher than the vertical segment of the facial nerve which were not exposed, and the vertical segment of the facial nerve in 9 patients, which were exposed, were 1-2 mm lower and 2-3 mm ahead or backward than the chorda tympani nerve. The horizontal semicircular and fossa incus were broken in 9 patients, of whom the vertical segments of the facial nerve were 1-2 mm lower and 2-3 mm ahead or backward than the chorda tympani nerve. The chorda tympani nerve of 1 patient were lower than the exposed vertical segment of facial nerve.Conclusion: The hyalinized chorda tympani nerve canal in mastoid segment can landmark the positon of facial ridge, and it would be the complement to the traditional method of landmarking vertical segment of facial nerve, especially for those whose horizontal semicircular canal and fossa incus had been broken.
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Key words:
- facial nerve /
- hyalinized /
- chorda tympani nerve
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