人類顳骨切片之鐙骨足板至砧骨長突距離之計測值

The Distance Between Footplate and Long Process of Incus Measured from Human Temporal Bone Sections

廖逸平(Yi-Ping Liao) ； 賴銘堂(Ming-Tang Lai) ； 袁聖博(Sheng-Po Yuan) ； 李飛鵬(Fei-Peng Lee)

《台灣耳鼻喉頭頸外科雜誌》 50卷4期 (2015/12) Pp. 234-241

https://doi.org/10.6286/2015.50.4.234

摘要

背景：實施鐙骨手術時，決定使用人工聽小骨之長度通常以鐙骨足板表面測量至砧骨長突中點之測量值作為選用之參考。文獻上雖然有諸多關於人類聽小骨之各種計測值，但多為離體組織之計測值；有關各聽小骨結構之間相對距離，文獻僅見影像學的實體計測值或手術中使用人工聽小骨植入物長度之統計值。顳骨標本切片內砧骨長突至鐙骨足板距離之計測值，則未見文獻報告。於顳骨切片下，實際計測砧骨長突與鐙骨足板距離可提供吾人於進行鐙骨相關手術時重要之參考數據。材料與方法：本研究取測成人顳骨切片共計15組，以Aperio ImageScope量測砧骨長突上、下緣，至鐙骨足板上、下緣之直線距離，得出砧骨長突之直徑以及鐙骨足板厚度之計測值，並據以計測砧骨長突中點到鐙骨足板之距離。結果：經量測15組顳骨切片中，砧骨長突上緣至鐙骨足板上緣之距離平均為4011.7 ± 306.9 μm(1,000 μm = 1 mm)；砧骨長突上緣至鐙骨足板下緣之距離平均為4147.1 ± 306.2 μm；砧骨長突下緣至鐙骨足板上緣之距離平均為3300.1 ± 328.3 μm；砧骨長突下緣至鐙骨足板下緣之距離平均為3435.2 ± 349.1 μm；砧骨長突之直徑為711.9 ± 127.9 μm；鐙骨足板厚度為135.4 ± 77.2 μm，而兩者之比率為5.2：1。鐙骨足板至砧骨長突中點之距離為3655.9 ± 317.6 μm。結論：砧骨長突中點至鐙骨足板上緣之距離為3655.9 ± 317.6 μm。砧骨長突直徑與鐙骨足板厚度的比率為5.2：1。鐙骨手術時選用人工聽小骨之長度，除了考慮砧骨長突至鐙骨足板間的距離之外，或許也可以考慮聽小骨自體及互相之間的大小、距離…等的可能性差異，以期能獲得更準確之適當的人工聽小骨長度的選用。

關鍵字

砧骨長突 ； 鐙骨足板 ； 顳骨

並列摘要

BACKGROUND: During stapes surgery, the selection of appropriate prosthesis depends on the distance between the surface of footplate and mid-long process of incus. In literature reviews, various methods of measurement were reported from isolated ossicles instead of direct histologic images. Therefore, the distance between long process of incus and footplate measured directly from temporal bone sections can provide important reference in stapes surgery. METHODS: Using Aperio ImageScope software, fifteen adult temporal bone sections were examined. The linear distances between upper and lower long process of incus and footplates were measured and then the diameter of long process of incus and thickness of footplate were calculated. Furthermore, the distance between long process of incus and footplate were calculated. RESULTS: In fifteen adult temporal bone sections, the average distance between the upper surface of long process of incus and upper surface of footplate was 4011.7 ± 306.9 μm (1,000 μm = 1 mm); the average distance between the upper surface of long process of incus and lower surface of footplate was 4147.1 ± 306.2 μm; the average distance between the lower surface of long process of incus and upper surface of footplate was 3300.1 ± 328.3 μm; the average distance between the lower surface of long process of incus and lower surface of footplate was 3435.2 ± 349.1 μm. The average diameter of long process of incus was 711.9 ± 127.9 μm. The average thickness of footplate was 135.4 ± 77.2 μm. The ratio of the diameter of long process of incus and the thickness of footplate was about 5.2 : 1. The average distance between footplate and mid-long process of incus was 3655.9 ± 317.6 μm. CONCLUSIONS: The average distance between mid-long incus process and upper surface of footplate was 3655.9 ± 317.6 μm. The ratio of the diameter of long process of incus and the thickness of footplate was about 5.2 : 1. During the stapes surgery, the choice of appropriate length of prosthesis may consider the distance between long process of incus and footplate with additional together with the variation of the structures and the relationship of incus and footplate of stapes.

並列關鍵字

long process of incus ； footplate of stapes ； temporal bone