To investigate the microscopic anatomy of internal auditory canal and facial nerve, vestibular nerve and vessel, and to discuss the advantages of neuroendoscopy in exploratory operation on internal auditory canal through inner listening crossing, which provide the anatomical references of surgery on acoustic neurinomas. Methods ① 15 skulls were observed and measured on 30 inner listening crossings and their adjacent bony structural a-natomy parameters; ② In 12 cadaveric heads, we simulated suboccipital retrosigmoid sinus approach to rub down posterior internal auditory canal and to dissect internal auditory canal and facial nerve, vestibular nerve. At the same time, we undertook multi-angle observation and comparison by neuroendoscopy. Results ①Internal auditory canal could be rapidly positioned by the relative positions of inner listening crossing and its adjacent structures. ② The relative position between facial nerve and vestibular nerve inside internal auditory canal was constant. We could find facial nerve by transverse ridge and vertical crest quickly. ③The structure inside internal auditory canal could be observed from inner listening crossing by neuroendoscopy. Conclusion ① Knowing well about anatomical structure of internal auditory canal, we can reduce postoperative complications of acoustic neuromas. ②In the acoustic neuromas in surgery, tumors in internal auditory canal can be removed by neuroendoscopy.%目的 研究内听道及其内面神经、前庭神经及血管显微解剖并探讨内窥镜技术经内听道口对内听道进行探查的作用,为临床听神经瘤手术提供解剖学参考.方法 ①对15具颅骨标本30侧内听道口与毗邻骨性结构进行观察测量;②在12具尸头上模拟枕下乙状窦后入路,磨除内听道后壁对内听道及内听道段面神经、前庭蜗神经进行观察测量,同时用神经内镜对内听道口进行多角度观察比较.结果 ①利用内听道口与毗邻结构的位置关系可快速定位内听道;②内听道内面神经与前庭蜗神经位置关系恒定;利用横嵴、垂直嵴可快速找到内听道段面神经; ③神经内镜经内听道口可观察到内听道内结构.结论 ①熟悉内听道解剖结构可减少听神经瘤术后并发症发生;②在听神经瘤手术中,可尝试在神经内镜下对内听道内肿瘤进行探查刮除而完成肿瘤全切.
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