耳内镜下Ⅰ型鼓室成形术困难外耳道的颞骨CT特点分析  

Characteristics of Temporal Bone CT Imaging in Cases of Difficult Transmeatal Endoscopic Type I Tympanoplasty

作　　者：张略 鲁慧 张全明 曾楠 胡璟 杨琼 ZHANG Lue;LU Hui;ZHANG Quanming;ZENG Nan;HU Jing;YANG Qiong(Department of Otolaryngology,Huazhong University of Science and Technology Union Shenzhen Hospital,Shenzhen 518053,China)

机构地区：[1]华中科技大学协和深圳医院耳鼻喉科,深圳518053

出　　处：《中华耳科学杂志》2024年第6期881-884,共4页Chinese Journal of Otology

摘　　要：目的分析耳内镜下Ⅰ型鼓室成形术中困难外耳道的颞骨CT影像学特点。方法回顾性纳入2021年1月至2022年11月华中科技大学协和深圳医院耳鼻喉科收治的慢性中耳炎患者43例,所有患者均由同一术者完成耳内镜下Ⅰ型鼓室成形术,分析外耳道成形术患者颞骨CT图像资料,对外耳道进行形态学评估及测量。结果43例慢性中耳炎患者中沙漏形外耳道35例(81.4%),锥形5例(11.6%),圆柱形2例(4.7%),卵圆形1例(2.3%)。外耳道最小宽径3.4~4.2 mm,平均(3.76±0.23)mm。外耳道下壁骨质隆起35例(81.39%),外耳道后壁隆起31例(72.09%),外耳道前壁隆起28例(65.12%)。外耳道下壁隆起角度127.2~159.5°,平均(143±12.27)°,外耳道前壁隆起角度129.8~167.7°,平均(147.76±13.89)°,外耳道后壁隆起角度131.8~166.2°,平均(149.0±11.48)°。外耳道下壁隆起角度小于外耳道前壁隆起角度、外耳道后壁隆起角度,差异均有统计学意义(P<0.05),外耳道后壁隆起角度与外耳道前壁隆起角度比较,差异无统计学意义(P>0.05)。结论耳内镜下Ⅰ型鼓室成形术中困难外耳道最常见形态为沙漏形,骨质隆起以外耳道下壁最为常见同时也更为明显,术前颞骨CT评估测量外耳道可作为辅助手段指导手术。Objective To describe characteristics of temporal bone computed tomography imaging in cases of difficult transmeatal endoscopic type I tympanoplasty.Methods Temporal bone CT image data from 43 patients with chronic otitis media admitted to the Department of Otorhinolaryngology,Huazhong University of Science and Technology Union Shenzhen Hospital,from January 2021 to November 2022 who underwent endoscopic typeⅠtympanoplasty by the same surgeon were retrospectively reviewed.External auditory meatus morphology and measurements were described.Results In the 43 patients(ears),the ear canal was hourglass-shaped in 35 ears,cone-shaped in 5 ears,cylinder-shaped in 2 ears and ovoid in 1 ear,with a mean width diameter of 3.76±0.23(3.4-4.2)mm.Overhanging was seen in the inferior canal wall in 35 cases(81.39%),in the posterior canal wall in 31 cases(72.09%),and in the anterior canal wall in 28 cases(65.12%),with the angle of inferior canal wall overhang(127.2-159.5°,143±12.27°)less than that of the anterior(129.8-167.7°,147.76±13.89°)and posterior(131.8-166.2°,149.0±11.48°)walls(P<0.05).Conclusion The most common external auditory canal morphology in difficult endoscopic typeⅠtympanoplasty is the shape of hourglass,while inferior canal wall overhang is the most common and more prominent.Preoperative temporal bone CT evaluation and measurement of the external auditory canal can be used to guide surgery.

关 键 词：耳内镜 Ⅰ型鼓室成形术 外耳道 颞骨CT 

分 类 号：R764.9[医药卫生—耳鼻咽喉科]