分泌性中耳炎患者咽鼓管和管周结构动态CT扫描和三维重建

发布时间：2018-10-14 11:09

【摘要】：目的观察分泌性中耳炎患者咽鼓管咽口开放和闭合状况,并了解管周结构、下鼻甲和咽隐窝对咽鼓管功能的影响。方法选取27例分泌性中耳炎(secretory otitis media,SOM)患者(SOM组),对其进行低剂量咽鼓管动态CT扫描,记录咽鼓管咽口的开放和闭合状况;对非分泌性中耳炎患者61例(对照组)进行鼻咽部CT薄层扫描,将两组患者的CT图像进行三维重建,观察下鼻甲及鼻咽部组织对应咽鼓管的关系,测量咽鼓管软骨段内侧壁的最大厚度,并观察咽隐窝的含气情况,分析以上因素对咽鼓管通气功能的影响。结果 27例SOM患者中23例咽鼓管咽口开放和闭合运动正常,4例明显可见肥大下鼻甲压迫咽鼓管前唇,咽口开放功能非常微弱;SOM患者患耳及健耳咽鼓管后壁最大厚度平均值分别为8.93±1.60mm和8.89±1.20mm,大于对照组(8.78±1.50mm),但差异无统计学意义(P0.05);SOM组患耳及健耳咽隐窝明显变浅或含气消失耳数分别为69.05%(29/42)与58.33%(7/12),明显高于对照组(17.21%,21/122),差异有统计学意义(P0.05)。结论咽鼓管通气功能下降可能与肥大的下鼻甲压迫咽鼓管前唇、咽鼓管圆枕及咽鼓管内侧壁粘膜慢性炎症、鼻咽部软组织的横向压迫等因素有关,其中鼻咽部软组织对咽鼓管特定软骨段的压迫可能是咽鼓管阻塞的重要原因。
[Abstract]:Objective to observe the opening and closing of pharynx of eustachian tube in patients with secretory otitis media, and to understand the influence of peritube structure, inferior turbinate and pharyngeal recess on eustachian tube function. Methods 27 patients with secretory otitis media (secretory otitis media,SOM) (SOM group) were examined by low-dose dynamic CT scanning of eustachian tube to record the opening and closing of pharyngeal mouth of eustachian tube. Sixty-one patients with unsecreted otitis media (control group) were scanned with thin layer nasopharynx (CT). The CT images of the two groups were reconstructed and the relationship between the inferior turbinate and nasopharyngeal tissue corresponding to the eustachian tube was observed. The maximum thickness of the medial wall of the cartilage segment of the eustachian tube was measured, and the gas content of the pharyngeal recess was observed, and the effect of the above factors on the ventilation function of the eustachian tube was analyzed. Results the pharyngeal opening and closing movement of eustachian tube was normal in 23 out of 27 patients with SOM, and hypertrophic inferior turbinate could be seen pressing the anterior lip of eustachian tube in 4 cases. The average maximum thickness of the affected ear and the posterior wall of the healthy ear eustachian tube in SOM patients was 8.93 卤1.60mm and 8.89 卤1.20mm, respectively, which was higher than that in the control group (8.78 卤1.50mm), but there was no significant difference (P0.05) in the); SOM group. The ear numbers were 69.05% (29 / 42) and 58.33% (7 / 12), respectively, which were significantly higher than those in the control group (17.21 / 122) (P0.05). Conclusion the decreased ventilation function of the eustachian tube may be related to the compression of the anterior lip of the eustachian tube by the hypertrophic inferior turbinate, the chronic inflammation of the mucosa of the eustachian tube occipital and the inner wall of the eustachian tube, and the transverse compression of the soft tissue of the nasopharynx. The compression of the soft tissue of nasopharynx on the specific cartilage segment of the eustachian tube may be an important reason for the obstruction of the eustachian tube.
【作者单位】：华中科技大学同济医学院附属同济医院耳鼻咽喉头颈外科;华中科技大学同济医学院附属同济医院放射科;
【分类号】：R764.21

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