Computer-assisted three-dimensional anatomic and surgical approach of the posterior ampullary nerve
- Author:
Pu DAI
1
;
Sichang JIANG
;
Yaoyun FANG
;
Jinzhu WANG
Author Information
1. 解放军总医院
- From:
Chinese Medical Journal
1998;111(4):0-0
- CountryChina
- Language:Chinese
-
Abstract:
Objective To establish a method for resuming the three dimensional shape of micro-structures in the inner ear and for designing the surgical approach of the posterior ampullary nerve (PAN) assisted by computer. Methods Four normal temporal bones were harvested within 24 hours after death and processed according to the traditional celloidin sectioning protocol. With the reference points to determine accurate orientation, the structural contours of each serial section were entered into an imaging computer via a digitizer. The data files were generated by a reconstruction software to display 3-D images of the structures on the computer monitor. The measuring software written by authors was adapted to obtain 3-D parameters and carry out surgical approach calculation and simulation of the PAN transection on the imaging computer.Results The lifelike 3-D images of the PAN and its neighboring structures and many important 3-D anatomic parameters were obtained. The PAN can be dissected completely and perfectly without damaging itself and its neighboring structures. For the exposure of the round window membrane (RWM), the postero-superior bony edge of the round window niche (RWN) was partially removed with a diamond bur. The limit in removing bony tissue of the RWN which suggested by the measuring results should be 1 mm superiorly and 2 mm posteriorly, otherwise the RWM might be damaged. A mathematical method which has the mid-point of inferior margin of the round window membrane as the reference point to find the PAN was built up. The 3-D surgical simulation of the PAN transection can be played step by step on the monitor.Conclusions The technique of computer-aided 3-D reconstruction which was introduced into the process of the micro-surgery's study and design, provides abundant anatomic knowledge and useful information for the PAN transection. In the near future, the technique of the computer-assisted surgery will be developed consummately and most operations will be performed more effectively and safely.
