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时间:2020-05-01
《先天性外中耳畸形的颞骨HRCT与手术对照研究.pdf》由会员上传分享,免费在线阅读,更多相关内容在行业资料-天天文库。
1、2013焦临床耳鼻咽喉头颈外科杂志27卷7期JClinOtorhin01aryngolHeadNeckSurg(China)·355·先天性外中耳畸形的颞骨HRCT与手术对照研究徐秀娟蒋中秋马华安严道南陈小宁许耀东。郑亿庆。[摘要]目的:借助颞骨HRCT探讨单双侧先天性外中耳畸形患者外耳、乳突、鼓室及听小骨的畸形程度,以利于术前分析及进行术式的选择。方法:选取诊断为先天性外中耳畸形的患者29例35耳(研究组),以研究组中单侧耳畸形患者对侧健耳23例(23耳)作为对照组,全部患者行颞骨HRCT扫描,其中19例(19耳)行手术探查,分析患者外中耳及颞骨发育情况,统计学检验耳廓畸形
2、与外耳道发育之间的关系,检验乳突气化程度与鼓室发育的关系;HRCT上行鼓室测量并进行对照分析。结合手术及HRCT表现,对听小骨常见锤砧骨畸形进行分类。结果:HRCT测量鼓岬至闭锁板的最短距离,对照组为(O.59±0.13)cm,单侧畸形组为(O.45士0.19)cm,双侧畸形组为(O.32±0.12)cm,单双侧畸形组分别与对照组比较,差异均有统计学意义。结合手术及HRCT检查,先天性外中耳畸形患者中听小骨正常1耳(2.86),镫骨足板固定5耳(14.29),无听骨3耳(8.57),锤砧骨畸形26耳(74.29)。锤骨与砧骨畸形常合并存在,畸形类型以锤骨退化、锤砧关节融合多见
3、。结论:先天性外中耳畸形患者耳廓畸形程度与外耳道畸形程度相关;乳突气化不良者鼓室发育亦差。HRCT上单侧畸形组鼓岬至闭锁板的最短距离较对照组缩短0.15cm,双侧畸形组较对照组缩短0.25cm。本研究组听小骨畸形以锤砧骨畸形为主,其中以锤骨退化、锤砧关节融合多见。[关键词]中耳;畸形;高分辨率CT[中图分类号]R764.72[文献标志码]A[文章编号]1001—1781(2013)07—0355—04ThestudybetweentemporalboneHRCTandoperationsincongenitalabnormalityofexternalandmiddleear
4、X【,XujuaT"lJIANGZhongqiuMAHuaanYANDaonanCHENXiaoningXUYaodongZHENGYiqing。(DepartmentofOtorhinolaryngoIogy,ChineseMedicineHospitalofJiangsuProvince,Nan—jing,210029,China;DepartmentofOtorhinolaryngology,SecondAffiliatedHospitalofSunYat—senUniversity)Correspondingauthor:XUYaodong,E—mail:gone—w
5、ind1980@163.comAbstract0bjective:Weexplorethedeformitydegreesofexternalear,mastoidprocess,tympaniccavityandauditoryossiclebytheHRCTfeaturesofbilateralandunilateralpatientsofcongenitalabnormalityofexternalandmiddleearforpreoperativeanalysisandselectionforsurgicalapproaches.Method:Twenty-nine
6、patientswereen—rolledinourstudy,andHRCTwereperformedonallpatients.Therewere23unilateralearsdeformity(13rightand10left),6patientswithbilateralearsdeformityinthestudygroup.Ninetecnpatients(19ears)weretreatedwithoperations.Result:Thedeformitydegreeofauriclewascorrelatedwiththatofexternalaudito
7、rymeatus,andmastoidprocessdevelopsbadaerationextentwithbadtympaniccavitydevelopmentin35earsinourresearch.WegotdataofshortestdistancefromtympaniccapetoatresicboardinHRCT,(0.59±0.13)cmincomparisongroup,(O.45士0.19)cminunilateraldeformitygroup,(O.32±0.12)cmi
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