人工耳蜗植入术前面神经管相关解剖的128层螺旋CT测量应用  

Application of 128 slice spriral CT in the measurement of anatomy of facial nerve canal before cochlear implantation

作　　者：王岚[1] 周艳玲[1] 张学梅[1] 李广盛[1] 

机构地区：[1]石家庄市第一医院CT室,河北省石家庄050000

出　　处：《中国基层医药》2013年第22期3427-3429,I0001,共4页Chinese Journal of Primary Medicine and Pharmacy

摘　　要：目的对人工耳蜗植入术患者面神经管进行影像学解剖及测量，为术中如何有效避免面神经损伤提供参考。方法人工耳蜗植入术患者35例，术前行128层螺旋CT薄层扫描，后通过多平面重组（MPR）及曲面重建（CPR）技术进行三维重建，参考后鼓室面隐窝人路人工耳蜗植入术面神经相关解剖，重点显示面神经管垂直段与面隐窝、鼓室等结构的相对关系。对颞骨内面神经管各段进行测量，并与35例人工耳蜗植入患者术中测量结果对照。结果35例患者行128层螺旋CT扫描，MPR及CPR技术三维重建后，能够清晰的显示面神经管各段，其垂直段与外耳道后壁、面隐窝距离分别为（3．31±0．88）mm、（1．89±0．29）mm，患者术中测量面神经管垂直段与外耳道后壁、面隐窝距离分别为（3．22±0．69）mm、（1．85±0．26）mm，差异无统计学意义（均P〉0．05）。35例患者无1例面瘫发生。结论128层螺旋CT薄扫，结合MPR及CPR技术，可了解面神经管与周围解剖标志的精细关系，可测量面神经管长度，可为人工耳蜗植入、颞骨及其他侧颅底手术如何避免面神经损伤提供依据。Objective To take the imaging anatomy and measurement of facial nerve canal for cochlear im- plantation patients, and to provide the reference for how to avoid the injury of facial nerve in the opreration. Methods 35 patients which would be given to cochlear implantation were taken 128 thin-slice CT scan preoperative, then using multi planar reformation （MPR） and curved planar reformation （CPR） techniques, the three-dimensional reconstruction were carried out, and referring the facial nerve anatomy of posterior tympanic facial recess approacharti- ficial cochlear implantation, the relationship between the vertical segment of facial nerve canal and facial recess, tym- panic cavity structure was key displayed. The tacial nerve canal sections in temporal bone were measured, and com- pared with measurement results of 35 cases of cochlear implant patients. Results 35 patients underwent 128-slice CT scan three-dimensional reconstruction of MPR and CPR techniques, the tacial nerve segment was clearly displayed, and its vertical section of the posterior wall of the external auditory canal ,facial recess distance was （3.31 ± 0.88 ） mm, （ 1.89 ± 0.29 ） mm, respectively, and the vertical segment of the facial nerve canal wall, the facial recess distance of intraoperative measurement was （ 3.22 ±0.69 ） ram, （ 1.85 ±0.26 ） mm, respectively, and there were no significant difference between the the both results （ all P 〉 0.05 ）. 35 patients had no case of face paralysis. Conclusion 128- slice spiral CT thin scan combined with MPR and CPR techniques can understand the facial nerve canal and surround- ing anatomical landmarks of the fine relationship, measurable facial nerve canal length, and provide basis for how to a- void facial nerve injury in the cochlear implant, temporal bone, and the other side of the skull base surgery.

关 键 词：耳蜗植入术 体层摄影扫描仪 X线计算机 面神经管测量 

分 类 号：R764[医药卫生—耳鼻咽喉科]