Abstract：
Cerebrospinal fluid rhinorrhea after temporal bone surgery involves drainage from the Eustachian tube (ET) into the nasopharynx, causing significant patient morbidity. Variable anatomy of the ET accounts for failures of currently used ET obliteration techniques.
To describe the surgical anatomy of the ET and examine possible techniques for ET closure through middle fossa (MF) and transmastoid approaches.
We described the surgical anatomy of the ET from the MF and transmastoid approaches in 5 adult cadaveric heads, measuring morphometric and surgical anatomy parameters and establishing targets for definite ET obliteration.
The osseous ET measured an average of 19.53 mm (±1.56 mm), with a mean diameter of 2.24 mm (±0.29 mm). The shortest distance between the greater superficial petrosal nerve and the ET junction was 6.61 mm (±0.61 mm). Shortest distances between the ET junction and the foramen spinosum and posterior border of the foramen ovale were 1.09 mm (±0.24 mm) and 2.03 mm (±0.30 mm), respectively. Closure of the cartilaginous ET may be performed by folding it in on itself, securing it by packing, suturing, or surgical clip ligation.
Definite obliteration of the cartilaginous ET appears feasible and the most definite approach to eliminate egress of cerebrospinal fluid to the nasopharynx using the MF approach. This technique may be used as an adjunct to skull base procedures where ET closure is planned.
To describe the surgical anatomy of the ET and examine possible techniques for ET closure through middle fossa (MF) and transmastoid approaches.
We described the surgical anatomy of the ET from the MF and transmastoid approaches in 5 adult cadaveric heads, measuring morphometric and surgical anatomy parameters and establishing targets for definite ET obliteration.
The osseous ET measured an average of 19.53 mm (±1.56 mm), with a mean diameter of 2.24 mm (±0.29 mm). The shortest distance between the greater superficial petrosal nerve and the ET junction was 6.61 mm (±0.61 mm). Shortest distances between the ET junction and the foramen spinosum and posterior border of the foramen ovale were 1.09 mm (±0.24 mm) and 2.03 mm (±0.30 mm), respectively. Closure of the cartilaginous ET may be performed by folding it in on itself, securing it by packing, suturing, or surgical clip ligation.
Definite obliteration of the cartilaginous ET appears feasible and the most definite approach to eliminate egress of cerebrospinal fluid to the nasopharynx using the MF approach. This technique may be used as an adjunct to skull base procedures where ET closure is planned.
摘要：
背景：颞骨手术后的脑脊液鼻漏涉及从咽鼓管（ET）到鼻咽部的引流，导致显著的患者发病率。ET的可变解剖结构解释了当前使用的ET闭塞技术的失败。
目的：描述ET的外科解剖结构，并研究通过中窝（MF）和乳突入路闭合ET的可能技术。
方法：我们描述了5例成人尸体头颅的MF和经乳突入路的ET的手术解剖，测量形态测量和手术解剖参数，并建立确定ET闭塞的目标。
结果：骨内皮素的平均值为19.53mm（±1.56mm），平均直径为2.24mm(±0.29mm)。较大的岩浅神经与ET交界处之间的最短距离为6.61mm（±0.61mm）。ET交界处与棘孔和卵圆孔后边界之间的最短距离为1.09mm（±0.24mm）和2.03mm（±0.30mm），分别。软骨ET的闭合可以通过将其折叠在自身上来进行，通过包装固定它，缝合,或手术夹结扎。
结论：使用MF方法消除脑脊液流入鼻咽的软骨ET的确定方法似乎是可行的，也是最明确的方法。此技术可用作计划进行ET闭合的颅底手术的辅助手段。
目的：描述ET的外科解剖结构，并研究通过中窝（MF）和乳突入路闭合ET的可能技术。
方法：我们描述了5例成人尸体头颅的MF和经乳突入路的ET的手术解剖，测量形态测量和手术解剖参数，并建立确定ET闭塞的目标。
结果：骨内皮素的平均值为19.53mm（±1.56mm），平均直径为2.24mm(±0.29mm)。较大的岩浅神经与ET交界处之间的最短距离为6.61mm（±0.61mm）。ET交界处与棘孔和卵圆孔后边界之间的最短距离为1.09mm（±0.24mm）和2.03mm（±0.30mm），分别。软骨ET的闭合可以通过将其折叠在自身上来进行，通过包装固定它，缝合,或手术夹结扎。
结论：使用MF方法消除脑脊液流入鼻咽的软骨ET的确定方法似乎是可行的，也是最明确的方法。此技术可用作计划进行ET闭合的颅底手术的辅助手段。
