背景:学习岩层金字塔的外科解剖可能是一个挑战,特别是在培训过程的开始。提供一个更容易,整体方法可以帮助每个有兴趣学习和教授颅底解剖学的人。我们使用一种易于理解和记忆的新隔室方法来介绍岩质金字塔解剖结构的复杂组织。
方法:检查了两个颞骨的岩层金字塔的表面;通过对上表面的渐进钻孔,暴露了8个颞骨的岩层金字塔的内容物。
结果:岩层金字塔是由一个骨状容器组成的,其内容物分为4个隔室(粘膜,皮肤,神经,和血管)。确定了在中耳水平相交的两条参考线(粘膜线和外耳道线)。然后描述了内容相对于这些参考线的定位,并提出了2种分割方法(X法和V法)。这个描述然后被用来描述中耳关系,面神经解剖学,和气囊分布。
结论:这种新的隔室方法可以全面了解岩层金字塔内容物的分布。把它分成解剖隔室,然后沿着特定的参考点导航这个心理地图,线条,空格,和段,可以创建一个有用的工具来教授或学习其复杂的三维解剖学。
BACKGROUND: Learning surgical anatomy of the
petrous pyramid can be a challenge, especially in the beginning of the training process. Providing an easier, holistic approach can be of help to everyone with interest in learning and teaching skull base anatomy. We present the complex organization of
petrous pyramid anatomy using a new compartmental approach that is simple to understand and remember.
METHODS: The surfaces of the
petrous pyramid of two temporal bones were examined; and the contents of the
petrous pyramid of 8 temporal bones were exposed through progressive drilling of the superior surface.
RESULTS: The
petrous pyramid is made up of a bony container, and its contents were grouped into 4 compartments (mucosal, cutaneous, neural, and vascular). Two reference lines were identified (mucosal and external-internal auditory canal lines) intersecting at the level of the middle ear. The localization of contents relative to these reference lines was then described, and 2 methods of segmentation (the X method and the V method) were then proposed. This description was then used to describe middle ear relationships, facial nerve anatomy, and air cell distribution.
CONCLUSIONS: This new compartmental approach allows a comprehensive understanding of the distribution of petrous pyramid contents. Dividing it into anatomic compartments, and then navigating this mental map along specific reference points, lines, spaces, and segments, could create a useful tool to teach or learn its complex tridimensional anatomy.