鼓室上的

Thirty two cases of middle ear cholesteatoma limited in epitympanum were treated.

目的 ：探讨提高局限于上鼓室的胆脂瘤型中耳炎疗效的手术方法。

Objective:To evaluate the therapeutic effects of epitympanum approach tympanotomy in treating traumatic ossicular chain disruption.

目的：评估完壁式上鼓室进路鼓室探查术治疗外伤性听骨链中断的临床疗效。方法：10例颞骨骨折和耳外伤而鼓膜完整的患者，颞骨CT轴位示锤砧关节不规整，冠状位示砧镫关节不连续。

Results:① The distance between handle of malleus and stapes head was(2.38±0.19)cm(2.00～2.70cm), the point selecting for measuring was outer margin of handle of malleus and stpes head.②The cross section form of one_third of the handle of malleus at the end, was triangle, the anteroposterior diameter of handle of malleus was(0.79±0.12)mm, the exterior and interior diameter was(0.58±0.10)mm at the crook point,the angle of line of manubrium mallei laid(83.24±8.33)°(66～98°)posteroinferior to arch of zygoma.③The long axis of prosthesis formed(27.60±1.75)°(24.6～30.2°)angle with the perpendicular of stapes.④The dependablity between the malleus_stapes distance and transverse diameter of tympanum, the location of umbo in tympanic membrane, the diameter of manubrium mallei, angle of line of manubrium mallei and arch of zygoma were not statistically significant.

结果：①锤_镫距离最短为(2.38±0.19)cm(2.00～2.70cm)，测量点为锤骨柄末端1/3处外缘和镫骨头；②锤骨柄末段1/3横断面形状接近三角形，弯曲处前、后方向直径为(0.79±0.12)mm，内、外方向直径为(0.58±0.10)mm；锤骨柄与颞线的成角为(83.24±8.33)°(66～98°)；③赝复物长轴与镫骨垂直方向成角平均为(27.60±1.75)°(24.6～30.2°)；④锤_镫距离与鼓室横径、鼓脐在鼓膜上的位置、锤骨柄直径、锤骨柄的方位的可能相关因素之间相关性检验无统计学意义。

Methods Twenty-two pieces of temporal bone were taken for this study. The mastoid cavity was opened, scutum removed,"bridge" broken down, posterior wall of external auditory canal abraded and the related anatomic structures were fully exposed. The distance between the origin of facial nerve canal and the anterior border of round window （ OOFNC-ABORW ）, between the highest point of the facial nerve canal and the bottom of posterior mastoid sinus,and between the stapes head and round window niche was measured under operating microscope.

方法取成人颞骨22侧（左右各11侧），用耳科钻磨开乳突腔，去上鼓室盾板、断"桥"，磨低骨性外耳道后壁，充分暴露相关结构，在手术显微镜下测量面神经管垂直段起始部前缘至圆窗龛前缘的距离、面神经管最高点与后鼓室底壁之间的距离、锥隆起的高度（即锥隆起基底到锥隆起顶端的距离）、镫骨头至圆窗龛前缘的距离。

Methods: Micranatomical study was carried out on 30 sides of human temporal bones to measure the location of umbo in tympanic membrane, the distance between handle of malleus and stapes head, the diameter of handle of malleus.

取成人完整鼓室标本15例(30侧)凿除乳突和外耳道前、后、下壁，保留上壁，在手术放大镜下测量鼓脐在鼓膜上的位置、锤骨柄至镫骨头距离、锤骨柄直径等。

Methods: 8 patient of cholesteatoma tympani with 10 ears were irrigated with 3% Purslane after oto-endoscopic.

对8例10耳单纯上鼓室胆脂瘤或伴外耳道后上壁部分缺损、CT示鼓窦、鼓室及乳突有软组织影的胆脂瘤型中耳炎采用耳内镜手术配合3%马齿笕溶液冲治疗。

Ten patients with temporal bone fracture and trauma of ear,whose CT scan of temporal bone showed that Malleoincudal joint irregular shape in the axial view and incudostapedial joint dislocation in the coronal view,were included in this study,Virtual endoscopy showed Malleoincudal joint separation,incudostapedial joint dislocation and interruption,ossicular chain disruptio...

虚拟耳镜示锤砧关节分离，砧镫关节脱位，听骨链中断。手术经颞线下开放上鼓室，保留完整的外耳道后上壁，充分暴露上、后鼓室和听骨链，检查并行听骨链成形术。结果：砧骨长脚骨折1耳，将砧骨改型后行锤-镫连接术；锤砧和砧镫关节脱位6耳，砧骨完全脱落3耳，行砧骨复位双关节固定术。10耳均行上鼓室进路鼓室探查术，术后语频听力平均提高25~50dB。结论：完壁式上鼓室进路鼓室探查术治疗外伤性听骨链中断疗效满意。

As for recurrence, the avoidance of a too-large postoperative tympanomastoid space, the establishment of a patent epi-mesotympanic route, and the preservation of adequate middle ear mucosa should be emphasized.

而避免术后中耳乳突腔过大，使上、中鼓室交通良好，以及尽量保持完整的中耳黏膜层，则是防止鼓膜再凹陷，再度形成胆脂瘤的良方。

Results: The angle that adjusting the reference line on the transverse plane is 32. 85°±6.76°, on the coronal plane is 14.15°±9.02°. The facial canal appears "ㄟ" on double oblique imaging geniculate ganglion, tympanic segment, post lap segment, mastoid segment were showed clearly. The achievement ratio is 100%. The segment displaying on double oblique imaging is more than transverse plane, coronal plane and sagittal plane.

结果：面神经管双斜位图像需要在横断位参考图像上旋转参考线的角度为32.85°±6.76°，在冠状位参考图像上旋转参考线的角度为14.15°±9.02°；在面神经管双斜位图像上，面神经管表现为&ㄟ&形，由前向后同时显示出膝状神经节、鼓室段、后膝部和乳突段；面神经管双斜位成像成功率为100%，面神经管行程的显示程度大于横断位、冠状位和矢状位。

Methods Twenty-two pieces of temporal bone were taken for this study. The mastoid cavity was opened, scutum removed,"bridge" broken down, posterior wall of external auditory canal abraded and the related anatomic structures were fully exposed. The distance between the origin of facial nerve canal and the anterior border of round window （ OOFNC-ABORW ）, between the highest point of the facial nerve canal and the bottom of posterior mastoid sinus,and between the stapes head and round window niche was measured under operating microscope.

方法取成人颞骨22侧（左右各11侧），用耳科钻磨开乳突腔，去上鼓室盾板、断&桥&，磨低骨性外耳道后壁，充分暴露相关结构，在手术显微镜下测量面神经管垂直段起始部前缘至圆窗龛前缘的距离、面神经管最高点与后鼓室底壁之间的距离、锥隆起的高度（即锥隆起基底到锥隆起顶端的距离）、镫骨头至圆窗龛前缘的距离。

Breath, muscle contraction of the buttocks; arch body, as far as possible to hold his head, right leg straight towards the ceiling (peg-leg knee in order to avoid muscle tension).

呼气，收缩臀部肌肉；拱起身体，尽量抬起头来，右腿伸直朝向天花板（膝微屈，以避免肌肉紧张）。

The cost of moving grain food products was unchanged from May, but year over year are up 8%.

粮食产品的运输费用与5月份相比没有变化，但却比去年同期高8％。