目  錄

1 顳骨 ......................................................................................................................... 1

Temporal Bone

 1.1 顳骨胚胎學 ...................................................................................................... 1

 1.1.1 軟骨性腦顱 .......................................................................................... 1

 1.1.2 膜性腦顱和鱗骨 .................................................................................. 3

 1.1.3 面顱 ...................................................................................................... 3

 1.2 圍產期顳骨的變化 .......................................................................................... 4

 1.3 出生后顳骨的變化 .......................................................................................... 4

 1.4 顳骨解剖 ......................................................................................................... 5

 1.4.1 巖骨 ...................................................................................................... 5

 1.4.2 鱗骨 ...................................................................................................... 5

 1.4.3 鼓骨 ...................................................................................................... 5

 1.4.4 莖突骨 .................................................................................................. 6

 1.4.5 顳骨裂 .................................................................................................. 6

 1.4.6 顳骨表面 .............................................................................................. 7

 1.5 結論 ............................................................................................................... 13

2 中耳 ....................................................................................................................... 15

Middle Ear Cavity

 2.1 鼓室外側壁 .................................................................................................... 15

 2.1.1 鼓室外側壁胚胎學 ............................................................................. 16

 2.1.2 鼓室外側壁解剖 ................................................................................ 16

 2.1.3 鼓膜力學 ............................................................................................ 21

 2.2 底壁（頸靜脈球壁） ...................................................................................... 24

 2.2.1 底壁胚胎學 ........................................................................................ 24

2.2.2 出生后頸靜脈球發育 ......................................................................... 24

 2.2.3 底壁解剖 ............................................................................................ 25

 2.3 后壁 ............................................................................................................... 27

 2.3.1 后壁胚胎學 ........................................................................................ 27

 2.3.2 后壁解剖 ............................................................................................ 27

 2.4 上壁（鼓室天蓋） .......................................................................................... 31

 2.4.1 上壁發育 ............................................................................................ 31

 2.4.2 上壁解剖 ............................................................................................ 32

 2.4.3 手術相關解剖 .................................................................................... 33

 2.4.4 蓋板裂隙與上半規管裂隙 ................................................................. 34

 2.5 前壁（頸內動脈壁） ...................................................................................... 36

 2.5.1 前壁的發育 ........................................................................................ 36

 2.5.2 前壁解剖 ............................................................................................ 36

 2.6 內壁（耳蝸壁） .............................................................................................. 38

 2.6.1 內壁的胚胎學 .................................................................................... 39

 2.6.2 內壁解剖 ............................................................................................ 41

3 中耳內容物 .......................................................................................................... 57

Middle Ear Contents

3.1 聽小骨 ........................................................................................................... 57

 3.1.1 聽小骨的胚胎學 ................................................................................ 57

 3.1.2 聽小骨解剖 ........................................................................................ 65

 3.2 聽小骨關節 .................................................................................................... 72

 3.2.1 聽小骨關節的胚胎學 ......................................................................... 72

 3.2.2 聽小骨關節解剖 ................................................................................ 72

 3.3 中耳肌肉 ....................................................................................................... 76

 3.3.1 中耳肌肉的胚胎學 ............................................................................. 76

 3.3.2 中耳肌肉解剖 .................................................................................... 76

 3.4 中耳神經 ....................................................................................................... 78

 3.4.1 面神經分支 ........................................................................................ 78

 3.4.2 鼓室叢 ................................................................................................ 78

 3.5 中耳血管 ....................................................................................................... 81

 3.5.1 中耳血管的胚胎學 ............................................................................. 81

 3.5.2 中耳血管解剖 .................................................................................... 83

3.6 中耳的黏膜皺襞 ............................................................................................ 86

 3.6.1 黏膜皺襞的發育 ................................................................................ 86

 3.6.2 黏膜皺襞解剖 .................................................................................... 86

 3.6.3 鼓室隔 ................................................................................................ 91

 3.6.4 鼓峽 .................................................................................................... 93

4 中耳室 .................................................................................................................. 99

Middle Ear Compartments

 4.1 中耳室胚胎學 ................................................................................................ 99

 4.1.1 前囊 .................................................................................................... 99

 4.1.2 中囊 .................................................................................................. 100

 4.1.3 上囊 .................................................................................................. 100

 4.1.4 后囊 .................................................................................................. 100

 4.2 原鼓室 ......................................................................................................... 100

 4.2.1 原鼓室的發育 .................................................................................. 100

 4.2.2 原鼓室解剖 ...................................................................................... 102

 4.3 下鼓室 ......................................................................................................... 103

 4.3.1 下鼓室各壁 ...................................................................................... 103

 4.3.2 下鼓室中的氣房 .............................................................................. 104

 4.4 后鼓室 ......................................................................................................... 104

 4.4.1 外側空間 .......................................................................................... 105

 4.4.2 中間隙 .............................................................................................. 106

 4.5 上鼓室 ......................................................................................................... 109

 4.5.1 上鼓室的上部單元 ........................................................................... 109

 4.5.2 上鼓室下端（鼓膜上隱窩） ............................................................. 113

 4.6 中鼓室 ......................................................................................................... 117

 4.6.1 鼓膜隔室或囊袋 .............................................................................. 117

 4.7 中耳通氣通路 .............................................................................................. 119

 4.8 中耳通氣壓力調節 ...................................................................................... 119

 4.8.1 中耳黏膜 .......................................................................................... 119

 4.8.2 黏膜細胞和 ET 壓力聯合調節 ......................................................... 121

 4.8.3 中耳壓力調節的神經控制 ............................................................... 122