虚拟CT耳镜评价先天性单纯性中耳畸形的临床应用

发布时间：2018-02-04 02:32

本文关键词： 虚拟CT耳镜中耳畸形先天性听骨链　出处：《临床耳鼻咽喉头颈外科杂志》2014年13期 　论文类型：期刊论文

【摘要】：目的:探讨虚拟CT耳镜评价先天性中耳畸形中听骨链病变的临床应用。方法:对13例(16耳)先天性中耳畸形患者行高分辨率CT扫描,将获取的原始图像数据经三维重建后,以虚拟CT耳镜的方式从不同角度与方向观察听骨链的病变情况,并依观察结果进行术前评估,将术前虚拟CT耳镜观察结果与手术探查结果对比分析。结果:13例(16耳)中耳畸形,虚拟CT耳镜发现5耳锤骨及砧骨上部结构发育不良或固定在上鼓室内壁,镫骨存在;3耳锤骨、砧骨及镫骨均发育不全或缺如,均经完壁式上鼓室进路行听骨链松解术或听骨链成形术;8耳为砧骨长脚或镫上结构发育不全、镫骨缺如或镫骨异位,经耳道内进路完成前庭窗开窗与人工镫骨手术。16耳术后外耳道和鼓膜均保存或恢复完好,语频听力平均提高25~45dB。手术探查听骨链畸形与术前虚拟CT耳镜观察符合率为100%。结论:虚拟CT耳镜是中耳畸形术前评估的重要参考依据。
[Abstract]:Objective: to evaluate the clinical application of virtual CT otoscope in the evaluation of ossicular chain lesions in congenital middle ear malformation. Methods: High-resolution CT scanning was performed in 13 patients with congenital middle ear malformation. After the original image was reconstructed by 3D, the lesion of ossicular chain was observed from different angles and directions by virtual CT otoscope, and the preoperative evaluation was carried out according to the observation results. The results of preoperative virtual CT otoscopy and surgical exploration were compared and analyzed. Results 13 cases (16 ears) of middle ear malformation were found. Virtual CT otoscope found 5 ears with malus and incus with dysplasia or fixed in the inner wall of the upper tympanic chamber and stapes. (3) the malus, incus and stapes were not completely developed or absent, and the ossicular chain release or ossicular chain angioplasty were performed through the wall approach to the tympanic cavity. 8 ears were the incus long foot or the structure of the stirrup were not developed completely, stapes were absent or stapes were ectopic, and the external meatus and tympanic membrane were well preserved or restored after the operation of artificial stapes and the fenestration of the vestibular window through the internal auditory canal approach. The coincident rate between operative exploration for ossicular chain malformation and virtual CT otoscopic observation before operation was 100. Conclusion:. Virtual CT otoscope is an important reference for preoperative evaluation of middle ear malformation.
【作者单位】：暨南大学附属第一医院耳鼻咽喉头颈外科;
【分类号】：R764.72
【正文快照】： 不伴外耳道闭锁和鼓膜异常的先天性中耳畸形临床较少见,二维CT显示中耳结构受限,术前CT检查常不能发现中耳畸形,或有时虽可发现中耳畸形,但难以评估鼓室及听骨链的空间立体构象,使手术探查往往有很大的盲目性或鼓室探查结果与术前评估不相符。基于虚拟现实技术的高分辨螺旋CT

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