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目的 :探讨经不同途径的中耳内窥镜解剖所见。方法 :采用 0°,30°,90°的硬质内窥镜 ,对 17个颞骨标本进行了观察 (其中干标本 6个 ,湿标本 11个 ) ,内窥镜插入途径有 :外耳道 ;耳后切口 (包括乳突腔 鼓窦和乳突腔 后鼓室两条亚途径 ) ;中颅窝。结果 :外耳道途径 :采用 0°,30° ,90°的硬质内窥镜 ,所有鼓室结构都可看见 ,包括鼓室窦、面隐窝、上鼓室前隐窝等隐蔽处 ;乳突腔 鼓窦途径 :可以看见乳突腔、鼓窦、上中鼓室等结构 ;乳突腔 后鼓室途径 :可观察到乳突及中下鼓室结构 ;中颅窝途径 :可以观察到上鼓室、鼓窦、乳突腔及鼓室外侧壁的结构 ,中鼓室的大部分结构亦可观察到。结论 :经不同的途径行内窥镜术能清楚地观察到中耳各个结构 ,因此能减少胆脂瘤的复发率及评价术后中耳腔的状态 ,其中 30°的内窥镜提供的视野较好 ;但如经外耳道途径观察后上鼓室及经乳突腔 鼓窦途径观察后鼓室 ,则 90°内窥镜较适合
Objective: To explore the different ways of endoscopic anatomy of the middle ear. Methods: 17 temporal bone specimens were observed with 0 °, 30 ° and 90 ° rigid endoscopes (6 of which were dry specimens and 11 of them were wet specimens). The pathways of endoscopic insertion were external auditory meatus, Incision (including the mastoid cavity and mastoid cavity of the posterior tympanic two sub-routes); in the cranial fossa. Results: The external auditory canal approach: All the tympanic structures were visible with 0 °, 30 ° and 90 ° rigid endoscopes, including concealed parts of the tympanic sinus, facial crypt, Pathway: You can see the mastoid cavity, the drum sinus, the upper drum chamber and other structures; mastoid cavity after tympanic approach: can be observed in the mastoid and the tympanic cavity structure; middle cranial fossa pathway: can be observed on the tympanic cavity, The structure of the buccal cavity and the tympanic lateral wall, most of the structure of the tympanic cavity can also be observed. CONCLUSIONS: The structures of the middle ear can be clearly observed through different pathways. Therefore, it can reduce the recurrence rate of the cholesteatoma and evaluate the condition of the middle ear cavity. The scope of the 30 ° endoscope provides a better visual field Good; but as observed by the external auditory canal after the tympanic cavity and mastoid sinus approach to observe the tympanic space, the 90 ° endoscope is more suitable