Objective To observe the anatomical constant sign of the parapharyngeal space operation via endoscopy-assisted transoral approach,and provide evidence for the treatment of the lesions of the pharyngeal space and improve the success rate of the operation. Methods CT multi plane reconstruction and three dimensional reconstruction were performed on 10 fresh dead bodies who were acquired from January 2015 to September 2015,the structure of the lateral pharyngeal space was observed,and the parapharyngeal space operation was performed via endoscopy-assisted transoral approach.Results The CT images showed that dispharynx of very low density extended posterior-lateral into the pharyngeal recess,lateral pharyngeal space located in the lateral pharyngeal recess,a low density triangular shadow with a nar-row of the front and width in the back,wing within muscles,wing outside muscles,masseter and temporal muscle located in the lateral pharyn-geal side clearance,which showed a medium density shadow,styloid process located in the front shadow of pharynx side clearance,the back of the internal carotid artery of pharynx side clearance,which showed medium density shadow.The blood vessels in the pharyngeal space and the nerve development was not clear.Stem styloid located in the temporal bone of the skull base drum subordinates,with length of (24.98 ± 2.01)mm,the internal structures of parapharyngeal space located in styloid process and around the surface of the deep muscular,the outside of styloid process had external carotid artery,facial nerve and mastoid.Inside of the base of styloid process had jugular vein foramen and hypo-glossal canal outside hole,the front inner side had carotid canal outside hole,the foramen spinosum,and oval foramen,the rear with stem hole.The distance between left and right side of root of styloid process to adjacent structures was compared,and the difference had no statisti-cal significance(P >0.05).In addition to the root of the styloid process to stylomastoid foramen.The difference of root of styloid process of males to adjacent structure was greater than that of the females,the difference had statistical significance(P <0.05).Conclusion Endo-scopic-assisted transoral approach to the parapharyngeal space operation hasthe styloid process as the marks of anatomy,the distance of styloid process to adjacent anatomical structures is as the reference,which helps to find and identify the parapharyngeal space of peripheral nerve, blood vessel,etc.

Objective To explore the effect of facial nerve decompression via mastoid-epitypanum approach on the treatment of early peripheral traumatic facial paralysis caused by temporal bone fracture.Methods The data of 21 patients with early peripheral traumatic facial paralysis caused by temporal bone fracture in our hospital from October 2011 to June 2016.The facial nerve electrogram and the blink reflex of the injured facial nerve of 21 patients who treated facial nerve decompression via mastoid-epitypanum approach were compared before and after operation.The degree of facial nerve function recovery was evluated by H-B grading method.Results The facial nerve function of all patients had improved in different degrees,85.7% patients recovered to Ⅰ~Ⅱ level.Compared with those before operation,the latency,amplitude and latent period of blink reflex of the ipsilateral facial electroneurography were significantly improved(P<0.05).Conclusion The facial nerve decompression has good effect in the treatment of early peripheral traumatic facial paralysis.

Objective To evaluate the influence of facet joint arthroplasty at different positions under lumbar percutaneous endoscopy on range of motion (ROM) of vertebral bodies by using the three-dimensional (3D) finite element method. Methods The 3D finite element model of normal L3-5 segment was established, and lumbar percutaneous endoscopy was simulated by doing cylindrical excision of bone with diameter of 7.5 mm on the tip or basement of L5 facet joint, so as to obtain normal lumbar vertebra model, L5 facet joint model with shaped tip, L5 facet joint model with shaped basement, respectively. Given specific loading conditions, the ROMs of adjacent vertebral bodies for the 3 models under flexion, extension, left and right lateral flexion, left and right rotation were compared. Results When L5 facet joint tip was shaped, the ROMs of L4-5 under extension，left lateral flexion, right lateral flexion, left rotation and right rotation were obviously larger than those of the normal model, especially under left rotation. When the L5 facet joint basement was shaped, the ROMS of L4-5 under left and right rotation increased slightly compared with those of the normal model. However, the ROMs of L3-4 for both tip-shaped and basement-shaped L5 facet joint model showed no obvious changes under six different motions. Conclusions The influence of L5 facet joint with shaped tip on ROMs of L4-5 was relatively larger than that of L5 facet joint with shaped basement under lumber percutaneous endoscopy. There was no significant effect on the ROMs of L3-4 with L5 facet joint arthroplasty.