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自Portmann介绍切开内淋巴囊(E L S)控制美尼尔氏病以来,已开展了以下数种手术:(1)E L S减压,(2)内淋巴-蛛网膜下分流,(3)内淋巴乳突分流。这些手术都需要辨明硬脑膜内的E L S。有些医生认为,少数病例的硬脑膜内E L S不可能看清;看不清的原因有人认为是由于外科技术差。他们认为手术时对发育不全的EL S也需看清。文中复习了有关ELS的解剖及找到或找不到E L S的文献报道。作者在外科医生配合下检查了50个颞骨以确定硬脑膜内E LS能否找到。有时需从颈静脉球下面到窦脑膜角上面和从乙状窦后面到面后气房区前下方和到后半规管前上部暴露颅后窝硬脑膜以辨识ELS。如可能,可在后半规管内侧钻洞,有助于发现发育不良的ELS。作者在48例中发
Since Portmann introduced cutting the endolymphatic sac (ELS) to control Ménière’s disease, several operations have been performed: (1) ELS decompression, (2) endolymphatic-arachnoid shunt, (3) endolymph Split mastoid. These procedures require the identification of E L S within the dura. Some doctors believe that in a small number of cases, the intradural E L S cannot be seen clearly; it is not clear that some people think that it is due to poor surgical techniques. They believe that underdevelopment of ELS should also be seen during surgery. The article reviews the anatomy of ELS and reports of finding or not finding E L S. The author examined 50 iliac bones with the surgeon to determine whether the E LS within the dura mater could be found. The posterior cranial fossa dura is sometimes exposed from beneath the jugular bulb to above the sinus meningeal angle and from behind the sigmoid sinus to the anterior posterior air space area and to the anterior part of the posterior semicircular canal to identify ELS. If possible, holes can be drilled inside the posterior semicircular canal to help detect stunted ELS. The authors issued in 48 cases