Objective To investigate the different exposure and treatment methods for the chorda tympanic nerve in middle ear surgery, and discuss the surgery techniques and the feasibility of the chorda tympanic nerve protection.Methods From September 2013 to March 2016, 155 cases of middle ear surgeries at Zhujiang hospital were included in this study, including 24 cases of type I tympanoplasty, 6 cases of atticotomy and type I tympanoplasty, 22 cases of atticotomy and type II tympanoplasty, 23 cases of canal-wall-up mastoidectomy and tympanoplasty,74 cases of canal-wall-down mastoidectomy and tympanoplasty, 6 cases of stapedotomy.The conditions of exposure and protection of the chorda tympanic nerve in the operation were compared, and their taste function at 3 days to 1 months postoperatively through questionnaires were evaluated.Results The preservation rate of the chorda tympanic nerve was up to 89.03%(138/155).There were 17 cases of chorda tympanic nerve injuries, of which 15 cases suffered hypogeusia with the rate being 88.2%(15/17).In 126 cases of the complete protection of the chorda tympanic nerve, 13 of them appeared hypogeusia at 10.3% (13/126), but they recovered within 1 months postoperatively.One case of delayed facial paralysis occurred in 16 days postoperatively, and recovered completely after 2 weeks of treatment with glucocorticoids.There was a significant difference in the incidence of postoperative abnormal taste between the complete protection of the chorda tympanic nerve and fracture during operation.Conclusion According to the different position and exposure of chorda tympanic nerve, the individual measures should be taken in middle ear surgery to protect the chorda tympanic nerve.

OBJECTIVETo investigate the related parameters of the temporal bone structure for determining the position of implanting electrode into the scala tympani in cochlear implantation surgery through the facial recess and epitympanum approach.

METHODSIn a surgical simulation experiment, 20 human temporal bones were studied and measured to determine the related parameters of the temporal bone structure.

RESULTSThe distance 5.91∓0.29 mm between the short process of the incus and the round window niche, 2.11∓0.18 mm between the stapes and the round window niche, 6.70∓0.19 mm between the facial nerve in the perpendicular paragraph and the round window niche, 2.22∓0.21 mm from the pyramidal eminence to the round window, and 2.16∓0.14 mm between the stapes and the round window. The minimal distance between the implanting electrode and the vestibular window was 2.12∓0.19 mm. The distance between the cochleariform process and the round window niche was 3.79∓0.17 mm. The position of the cochlear electrode array insertion into the second cochlear turn was 2.25∓0.13 mm under the stapes. The location of the cochlear electrode array insertion into the second cochlear turn was 2.28∓0.20 mm inferior to the pyramidal eminence.

CONCLUSIONThese parameters provide a reference value to determine the different positions of cochlear electrode array insertion into the scale tympani in different patients.

Adult ; Cochlea ; anatomy & histology ; surgery ; Cochlear Implantation ; Cochlear Implants ; Ear, Middle ; anatomy & histology ; surgery ; Female ; Humans ; Male ; Round Window, Ear ; anatomy & histology ; surgery ; Scala Tympani ; anatomy & histology ; surgery

OBJECTIVE: To investigate the related parameters of temporal bone structure in the surgery of cochlear implantation through facial recess approach so as to offer a theoretical reference for the avoidance of facial nerve injury and the accurate localization. METHOD: In a surgical simulation experiment, twenty human temporal bones were studied. The correlation parameters were measured under surgical microscope. RESULT: Distance between suprameatal spine and short process of incus was (12.44 +/- 0.51) mm. Width from crotch of chorda tympani nerve to stylomastoid foramen was (2.67 +/- 0.51) mm. Distance between short process of incus and crotch of chorda tympani nerve was (15.22 +/- 0.83) mm. The location of maximal width of the facial recess into short process of incus, crotch of chorda tympani nerve were (6.28 +/- 0.41) mm, (9.81 +/- 0.71) mm, respectively. The maximal width of the facial recess was (2.73 +/- 0.20) mm. The value at level of stapes and round window were (2.48 +/- 0.20 mm) and (2.24 +/- 0.18) mm, respectively. Distance between pyramidalis eminence and anterior round window was (2.22 +/- 0.21) mm. Width from stapes to underneath round window was (2.16 +/- 0.14) mm. CONCLUSION These parameters provide a reference value to determine the position of cochlear inserting the electrode array into the scale tympani and opening facial recess firstly to avoid potential damage to facial nerve in surgery.
Anatomic Landmarks ; anatomy & histology ; Chorda Tympani Nerve ; anatomy & histology ; Cochlea ; anatomy & histology ; Cochlear Implantation ; methods ; Ear, Middle ; Facial Nerve Injuries ; prevention & control ; Humans ; Incus ; anatomy & histology ; Organ Sparing Treatments ; methods ; Round Window, Ear ; anatomy & histology ; Stapes ; anatomy & histology ; Temporal Bone ; anatomy & histology ; Tympanic Membrane ; anatomy & histology