先天性外中耳畸形面神经管乳突段前位MSCT研究  

The study of mastoid segment anteposition of facial canal in the congenital external and middle ear malformation by MSCT

作　　者：杨想春[1] 闫锐[1] 董季平[1] 杨军乐[1] 宁文德[1] 邬小平[1] 马鸣岳[1] 刘红生[1] 

机构地区：[1]西安交通大学医学院附属西安市中心医院放射科,陕西西安710003

出　　处：《实用放射学杂志》2014年第1期49-51,共3页Journal of Practical Radiology

摘　　要：目的利用多层螺旋CT观察、测量并分析先天性外中耳畸形患者面神经管乳突段是否前位。方法对正常组182例（335耳，均为6岁以上）及先天性外中耳畸形组35例（49患耳，6岁以上41耳，6岁以下8耳）行轴位HRCT扫描，在多平面重组（MPR）冠状面上行面神经管曲面重组（CPR），测量双侧面神经管乳突段中点前缘至膝状神经窝前缘连线的垂直距离，并做统计学分析。结果（1）正常组面神经管乳突段走行：向正下方走行占59．70％（200／335），向前下走行占22．09％（74／335），向后下走行占18．21％（61／335）。（2）面神经管乳突段中点前缘距膝状神经窝前缘连线的垂直距离：①6岁以上畸形组41耳为（7．80土2．56）mm，正常组335耳为（10．02±2．07）mm，二者有显著统计学差异（P〈O．05）；②6岁以上29例单耳畸形者距离：正常侧为（9．86±2．95）mm，畸形侧为（7．68±2．60）mm，二者有显著统计学差异（P〈O．05）；③单耳畸形及双耳畸形的测量距离：29例单耳畸形为（7．68±2．60）mm，10例（20耳）双耳畸形为（8．34±2．71）mm，二者无显著统计学差异（P〉O．05）；④6岁以上畸形耳及6岁以下畸形耳的测量距离：6岁以上41耳为（7．80±2．56）mm，6岁以下8耳为（5．60±2．24）mm，二者有显著差异（P〈O．05）。结论正常面神经管乳突段可向前下、正下或后下走行；先天性外中耳畸形患侧面神经管乳突段常有前位；术前观察面神经管乳突段的位置，有助于避免术中损伤面神经。Objective To observe and measure mastoid segment anteposition of facial canal in congenital external and middle ear malformation by MSCT. Methods HRCT scanning was performed on 182 cases （335 normal ears） of patients over 6 years old and 35 cases （49 abnormal ears） with congenital external and middle ear malformation （41 ears over 6 years old and 8 ears under 6 years old）. Then, curved planar reformation （CPR} was post-processing and the distance from the front edge midpoint of mastoid segment of facial canal to the anterior border of genicular fossa was measured. Results OPositions of mastoid segment of facial canal were straight down （59.70%, 200/335）, anterior down （22.09%, 74/335）, and posterior down （18. 21% , 61/335 ）. （2）The distances from the front edge midpoint of mastoid segment of facial canal to the anterior border of genicular fossa were （7.80±2.56） mm in malformation group, （10.02±2.07） mm in normal group （P〈O. 05）. Gin 29 cases who was over 6 years old with unilateral mal- formation group, the distance of normal side was （9.86±2.95） ram, that of abnormal side was （7.68±2.60） mm（P〈0.05）. （4） The distance in bilateral malformation group （10 cases, 20 ear） was （8.34±2.71 ） ram, the difference between unilateral and bilat- eral malformation groups had no statistic significance （P〉0.05）. （5）The distance in 8 ears under 6 years old malformation group was （5.60±2.24） mm. It had significant difference of statistics （P〈0.05） between over 6 years old group and under 6 years old malformation group. Conclusion Position of mastoid segment of facial canal can be classified as inferior, anterior and posterior direc- tions. Mastoid segment of facial canal in congenital external and middle ear malformation is often anteposition. The study of the po- sition of mastoid segment of facial canal before operation can help to avoid damaging facial nerve.

关 键 词：面神经管 颞骨 先天畸形 计算机体层成像 

分 类 号：R745.12[医药卫生—神经病学与精神病学] R764.72[医药卫生—临床医学]