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首页> 外文期刊>The Laryngoscope: A Medical Journal for Clinical and Research Contributions in Otolaryngology, Head and Neck Medicine and Surgery, Facial Plastic and Reconstructive Surgery .. >Relationship of the facial nerve to the tympanic annulus: a direct anatomic examination.
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Relationship of the facial nerve to the tympanic annulus: a direct anatomic examination.

机译：面神经与鼓膜环的关系：直接解剖检查。

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OBJECTIVE: To examine the relation of the facial nerve to the only identifiable surgical landmark in the external auditory canal. INSTITUTION: Community-based teaching hospital. STUDY DESIGN: Examination of formalin-fixed human temporal bones. BACKGROUND: The transcanal approach is often used in tympanoplasty, canaloplasty, hypotympanotomy, and removal of tumors of the external auditory canal (EAC), such as exostoses and osteomas. Surgery of the EAC places the facial nerve at risk for injury as the nerve courses vertically in the posterior canal wall. Few articles have described the relation of the facial nerve's course to the tympanic annulus, the only identifiable landmark in the EAC. This study is the first to document the relationship of the course of the facial nerve with respect to the tympanic annulus by direct anatomic measurement of the temporal bone. METHODS: Thirty-seven formalin-fixed cadaver temporal bones were studied after skeletonization of the facial nerve and tympanic annulus. RESULTS: The facial nerve coursed lateral to the plane of the annulus in 70% of specimens, always in the posteroinferior quadrant. The nerve also coursed anterior to a plane through the most posterior point of the annulus in 73.1% of specimens, also exclusively in the posteroinferior quadrant. The course of the nerve was quite variable with respect to the annulus. CONCLUSIONS: The facial nerve is most vulnerable to injury in the posteroinferior quadrant in transcanal surgery. The annulus is not a reliable landmark for the facial nerve. Anecdotal evidence is cited and recommendations are offered.
机译：目的：研究面神经与外耳道中唯一可识别的手术标志的关系。机构：社区教学医院。研究设计：检查福尔马林固定的人类颞骨。背景：经导管入路通常用于鼓膜成形术，根管成形术，下鼓室切开术和外耳道（EAC）的肿瘤（例如外生骨和骨瘤）的切除。 EAC的手术使面神经在后管壁中垂直行进，因此有受伤的危险。很少有文章描述面神经路线与鼓膜环的关系，鼓膜环是EAC中唯一可识别的标志。这项研究是第一个通过对颞骨进行直接解剖测量来记录面神经相对于鼓膜环的关系的文件。方法：在将面神经和鼓膜环骨化后，研究了37颗福尔马林固定的尸体颞骨。结果：在70％的标本中，面神经在环平面的侧面行进，始终位于后下象限。在73.1％的标本中，神经也从平面的前部穿过环的最后点，也仅在后下象限内。相对于瓣膜环，神经的活动过程变化很大。结论：经导管手术中，面神经在后下象限最容易受伤。环面不是面神经的可靠标志。引用轶事证据并提供建议。

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