颞骨CT对人工耳蜗植入术难易程度及神经损伤风险的评估价值  

The Estimated Value of Temporal CT for Complexity and Neurological Injury in Cochlear Implantation

作　　者：杨屈扬[1] 秦兆冰[1] 李素娟[1] 张帆[1] 孟娟[1] 

机构地区：[1]郑州大学第一附属医院耳鼻咽喉头颈外科,郑州450052

出　　处：《听力学及言语疾病杂志》2013年第4期335-337,共3页Journal of Audiology and Speech Pathology

摘　　要：目的探讨CT对人工耳蜗植入术难易程度及面神经和鼓索神经损伤风险的评估价值。方法对拟行人工耳蜗植入、CT显示无中耳和内耳畸形的80例(80耳)1～6岁重度或极重度感音神经性听力损失患儿,术前进行颞骨CT轴位片相关解剖标志的测量,记录圆窗龛层面自面神经垂直段前缘至外耳道后壁的垂直距离,并与术中圆窗龛对应处面隐窝轮廓化的面神经前缘至轮廓化的鼓索神经后缘的实测距离进行比较,研究其相关性。结果颞骨轴位CT圆窗龛层面面神经到外耳道后壁的平均距离为4.04±0.22mm,术中通过轮廓化面神经垂直段与鼓索神经,二者在面隐窝圆窗龛对应处实测距离为2.35±0.28mm,相关性分析显示二者呈正相关,相关系数r=0.779。当手术中的实测该距离为1.5mm时,术前CT图像测得为3.5mm。结论颞骨轴位CT圆窗龛层面面神经到外耳道后壁的垂直距离与术中相对应处面神经到鼓索神经的实测距离成正相关,当CT显示该距离小于3.5mm时,提示手术难度和神经损伤的风险增加。Objective To study the most opening wide range of facial nerve recess displaying by temporal bone high resolution CT,compare with intraoperative measured distance,and explore assessment value of CT in difficulty about artificial cochlear implantation and injury risk of facial nerve and chorda tympani nerve.Methods The relevant anatomy marks were measured in preoperative axial temporal bone CT from 80cases of 1～6years old children intending to cochlear implanting.The vertical distance of round window level from the facial nerve vertical section front to external auditory meatus back wall were recorded and compared with the measured distance from outline stroke of facial nerve front corresponding to surface crypts round window recess to outline stroke of chorda tympani nerve edge.Results In the round window level of axial temporal bone CT,the average distance from facial nerve to external auditory meatus back wall was 4.04±0.22mm.Through the outline change of facial nerve vertical section and chorda tympani nerve during the operation,the both measured distance in the round window membrane corresponding place was 2.35±0.28mm.The correlation analysis of data showed a positive correlation,and the correlation coefficient was r=0.779.The intraoperative measured distance was 1.5mm,the distance from facial nerve to external auditory meatus back wall measured by CT image was 3.5mm.Conclusion In the round window recess level of axial temporal bone CT,the vertical distance from facial nerve to external auditory meatus back wall and the measured distance from corresponding operation in facial nerve to chorda tympani nerve had positive correlation.When the distance from facial nerve to external auditory meatus back wall was less than 3.5mm,it prompted inerease of operation difficulty and risk of nerve injury.

关 键 词：人工耳蜗植入 面神经隐窝 电子计算机断层扫描 手术 

分 类 号：R764.5[医药卫生—耳鼻咽喉科]