儿童耳部正常解剖结构的MSCT数据测量及其发育特点

发布时间：2018-06-17 01:20

本文选题：多层螺旋CT + 正常值　；参考：《山西医科大学》2011年硕士论文

【摘要】：目的：测量0-15岁正常儿童外耳、中耳、内耳解剖数据,探讨我国儿童正常颞骨影像学特点,为临床、教学、科研提供帮助。材料与方法：随机选取山西省儿童医院0-15岁无耳疾患的96例病例先行多层螺旋CT(multi-slice spiral computed tomography, MSCT)扫描检查,获得原始图像后行多平面重组(multi-planar reformation, MPR)得到测量图层,并在设定的层面上对颞骨各主要结构的径线进行测量,记录正常数值。再对各参数进行年龄组间及性别组间的统计学分析。结果：(1)外耳：外耳道峡部前后径3.58±0.83mm。(2)中耳：鼓室上隐窝长度4.18±1.13mm；鼓室上隐窝宽度3.47±0.82mmm；上鼓室前后径6.90±1.02mm；上鼓室左右径5.58±0.88mm；鼓窦入口宽度2.50±0.57mmm；鼓窦深度10.60±3.01mm；鼓室窦深径3.19±0.80mm。(3)内耳：耳蜗高度3.63±0.54mm；耳蜗基底转长度6.15±1.05mmm；耳蜗基底转宽度1.27±0.28mm；前庭上下径5.43±0.50mm；前庭左右径2.86±0.35mm；外半规管骨岛宽度3.93±0.52mm；上半规管骨岛宽度6.10±0.63mmm；内听道长度为6.53±1.05mm；内听道口径5.76±1.64mm；内听道宽径4.31±0.83mm；蜗神经孔横径2.12±0.51mm。(4)面神经：面神经迷路段长度3.04±0.68mm；面神经迷路段宽度0.88±0.38mm；面神经鼓室段长度9.40±3.15mm；面神经鼓室段距砧骨短脚尖端最短距离2.41±0.79mm；面神经乳突段到外耳道后壁距离为2.74±0.63mm；面神经乳突段到外耳门后缘距离14.6±4.39mm：面神经乳突段到乙状窦沟前壁距离：11.18±1.55mmm。(5)乳突：乳突高度为22.49±9.18mm；测得乳突前后径为18.96±5.44mm；乙状窦距外耳道后壁距离12.94±1.71mm。(6)各年龄组测量数据无性别差异。鼓室上隐窝长度、上鼓室左右径、鼓窦入口宽度、耳蜗高度、前庭上下径与左右径、外半规管骨岛宽度、上半规管骨岛宽度、蜗神经孔横径、面神经鼓室段距砧骨短脚尖端最短距离、面神经乳突段到乙状窦沟前壁距离等指标在各年龄组间无显著性差异。外耳道峡部、鼓室窦深径、耳蜗基底转长度及宽度、内听道长度、内听道宽径、面神经乳突段到外耳道后壁或到外耳门后缘距离在1岁内发育明显；鼓室上隐窝出生后的发育是以宽度变化为主；上鼓室前后径以5岁前发育明显；鼓窦发育主要在出生后1-5岁；内听道口径、面神经迷路段宽度、面神经鼓室段长度、乳突、乙状窦到外耳道后壁距离出生后到15岁不断发育中。结论：(1)骨性外耳道的研究可从生后2月儿童开始；骨性外耳道狭窄的诊断标准4mm并不适用于6岁以下儿童。(2)内耳的结构中耳蜗、前庭、半规管的骨性结构不受年龄因素影响；(3)外耳、中耳大部分结构以及内听道的发育各有其年龄特点,提示在临床诊断及手术时应充分考虑到年龄因素。
[Abstract]:Objective: to measure the anatomical data of external ear, middle ear and inner ear of normal children aged 0 to 15 years, and to explore the imaging features of normal temporal bone of children in China, so as to provide help for clinical, teaching and scientific research. Materials and methods: 96 patients aged 0-15 years without ear disease in Shanxi Children's Hospital were randomly selected to be examined by multi-slice spiral computed tomography, MSCT. After obtaining the original images, the multiplanar reconstruction multi-planar reformation (MPRR) was performed to obtain the measurement layer. The diameter of the main structures of the temporal bone was measured at the set level and the normal values were recorded. Then the parameters were analyzed between age groups and sex groups. Results: the outer ear: the anterior and posterior diameter of the isthmus of the external auditory meatus was 3.58 卤0.83mm.f2) the middle ear: the length of the superior tympanic recess was 4.18 卤1.13mm, the width of the superior tympanic recess was 3.47 卤0.82mm, the anteroposterior diameter of the ependympanic chamber was 6.90 卤1.02mm, the right and left diameters of the epigmpanic chamber were 5.58 卤0.88mm, the width of the entrance to the tympanic sinus was 2.50 卤0.57mm, the depth of the tympanic sinus was 10.60 卤3.01mm; The depth diameter of tympanic sinus was 3.19 卤0.80mm.Sp3) inner ear: cochlear height 3.63 卤0.54mm; cochlear basal rotation length 6.15 卤1.05mm; cochlear basal rotation width 1.27 卤0.28mm; vestibular inferior diameter 5.43 卤0.50mm; vestibular diameter 2.86 卤0.35mm; width of outer semicircular canal bone island 3.93 卤0.52mm; width of superior semicircular canal bone island 6.10 卤0.63mm; length of inner auditory canal 6.53 卤1.05mm; The length of the labyrinthine segment of the facial nerve was 3.04 卤0.68 mm, the width of the labyrinthine segment of the facial nerve was 0.88 卤0.38 mm, the length of the tympanic segment of the facial nerve was 9.40 卤3.15 mm, the shortest distance from the tympanic segment of the facial nerve to the tip of the short foot of the incus was 2.41 卤0.79 mm, the width of the inner auditory canal was 5.76 卤1.64 mm, the width of the inner auditory canal was 4.31 卤0.83 mm, the transverse diameter of the cochlear foramen was 2.12 卤0.51 mm. The distance between the mastoid segment of the facial nerve and the posterior wall of the external auditory canal was 2.74 卤0.63 mm, the distance between the mastoid segment of the facial nerve and the posterior margin of the external auditory canal was 14.6 卤4.39 mm, and the distance between the mastoid segment of the facial nerve and the anterior wall of the sigmoid sinus sulcus was: the height of the mastoid process was 22.49 卤9.18 mm, the diameter of the anterior and posterior mastoid process was 18.96 卤5.44 mm. The distance between sigmoid sinus and posterior wall of external auditory canal was 12.94 卤1.71 mm. Length of superior tympanic recess, left and right diameter of superior tympanic chamber, width of inlet of tympanic sinus, height of cochlea, superior and inferior diameter of vestibular vestibule, width of bone island of outer semicircular canal, width of bone island of superior semicircular canal, transverse diameter of foramen of cochlear nerve. There was no significant difference in the distance between the tympanic segment of the facial nerve and the tip of the short foot of the incus and the distance between the mastoid segment of the facial nerve and the anterior wall of the sigmoid sinus sulcus. The isthmus of the external auditory meatus, the deep diameter of the tympanic sinus, the length and width of the cochlear basal conversion, the length of the internal auditory canal, the width of the internal auditory canal, the distance from the mastoid segment of the facial nerve to the posterior wall of the external auditory canal or to the posterior margin of the external auditory canal developed significantly within 1 year of age. The width of the supratympanic recess was mainly changed after birth, the anterior and posterior diameter of the superior tympanic cavity was obviously developed before the age of 5 years, the development of the tympanic sinus was mainly between 1 and 5 years after birth, the caliber of the internal auditory canal, the width of the labyrinthine segment of the facial nerve, the length of the tympanic segment of the facial nerve, the mastoid process, The sigmoid sinus to the posterior wall of the external auditory canal continues to develop from birth to 15 years of age. Conclusion the study of osseous external auditory meatus can begin at 2 months after birth, the diagnostic criteria of osseous external auditory canal stenosis (4mm) is not applicable to children under 6 years of age) the middle cochlea, vestibule and semicircular canal are not affected by age factors. 3) most of the structures of the external and middle ears and the development of the internal auditory canal have their own age characteristics, which suggests that the age factors should be fully taken into account in the clinical diagnosis and operation.
【学位授予单位】：山西医科大学
【学位级别】：硕士
【学位授予年份】：2011
【分类号】：R764

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