单侧慢性化脓性中耳炎颞骨CT解剖学研究

doi:10.13418/j.issn.1001-165x.2022.2.09

PDF(2197 KB)

中国临床解剖学杂志 ›› 2022, Vol. 40 ›› Issue (2) : 164-167. DOI: 10.13418/j.issn.1001-165x.2022.2.09

断层影像解剖

单侧慢性化脓性中耳炎颞骨CT解剖学研究

胡瑞利¹，　张晓辰²，　邹殿俊²，　张青俊¹，　林彦涛¹，　梁占东²

作者信息 +

CT anatomical research of temporal bone in unilateral chronic otitis media

Hu Ruili¹, Zhang Xiaochen², Zou Dianjun², Zhang Qingjun¹, Lin Yantao¹, Liang Zhandong²

Author information +

文章历史 +

摘要

目的研究单侧慢性化脓性中耳炎颞骨CT解剖学特征及其临床意义。方法回顾性分析35例单侧非胆脂瘤型慢性化脓性中耳炎患侧颞骨（病例组）与健侧颞骨（对照组）CT影像资料，比较两组咽鼓管外耳道角、岩枕角、乳突窦入口直径、咽鼓管骨部直径、咽鼓管骨部长度、咽鼓管骨部最大径与咽鼓管骨部长度之比，及乳突气化程度（良好、差）等解剖参数。结果患侧咽鼓管外耳道角、岩枕角分别是（137.4 ± 8.1）°、（52.5 ± 3.8）°，乳突窦入口直径、咽鼓管骨部最大径分别是（0.29±0.08）cm、（0.18±0.07）cm，咽鼓管骨部长度为（1.07±0.15）cm，咽鼓管骨部最大径与骨部长度之比为（17.1±5.4）%；健侧咽鼓管外耳道角、岩枕角分别是（138.3±7.7）°、（53.1±4.3）°，乳突窦入口直径、咽鼓管骨部最大径分别是（0.35±0.07）cm、（0.21±0.07）cm，咽鼓管骨部长度为（1.17±0.17）cm，骨部最大径与骨部长度之比为（20.9±14.3）%。患侧乳突窦入口直径、咽鼓管骨部最大径、咽鼓管骨部长度较健侧小，差异具有统计学意义（t = 4.37、3.09、－3.17，P<0.05）。患侧乳突气化较健侧差，差异具有统计学意义（χ2 = 6.34，P<0.05）。患侧与健侧咽鼓管外耳道角、岩枕角及咽鼓管骨部最大径与咽鼓管骨部长度之比差异无统计学意义（P>0.05）。结论单侧慢性化脓性中耳炎患侧颞骨存在解剖变异。咽鼓管骨部小、乳突气化差及乳突窦入口狭窄与单侧慢性化脓性中耳炎相关。

Abstract

Objective　To study the CT anatomical features and the clinical significance of temporal bone in unilateral chronic otitis media(COM).　Methods　The CT images of 35 patients with unilateral COM on the affected side (an experimental group) and the healthy side (a control group) of temporal bone were analyzed retrospectively. Auditory tube angle（ATA）, petroclival angle（PCA）, diameter of aditus mastoid（DA）, diameter（D）and length（L）of osseous segments of Eustachian Tube, the ratio of maximum diameter and length(D/L) of osseous segments of Eustachian Tube and mastoid pneumatization of the two groups were compared.　Results　In the experimental group, the ATA and the PCA of were (137.4±8.1)°, (52.5±3.8)°, respectively, DA and D were (0.29±0.08) cm, (0.18±0.07) cm, respectively, L was (1.07±0.15) cm and D/L was (17.1±5.4) %. In the control group, the ATA and the PCA of were (138.3±7.7)°, (53.1±4.3)°, respectively, DA and D were (0.35±0.07) cm, (0.21±0.07) cm, respectively, L was (1.17±0.17) cm and D/L was (20.9±14.3) %. There was significant difference in the result of DA, D and L of osseous segments of Eustachian Tube and mastoid pneumatization between experimental group and control group (t/χ2=4.37, 3.09, －3.17, 6.34, P<0.05). There was no significant difference in the result of ATA, PCA, D/L between experimental group and control group (P>0.05). Conclusions There is anatomic variation in the temporal bone of patients with unilateral chronic suppurative otitis media. The small osseous segments of Eustachian Tube, narrow entrance of aditus mastoid and poor mastoid pneumatization are associated with unilateral COM.

导出引用

胡瑞利, 张晓辰, 邹殿俊, 张青俊, 林彦涛, 梁占东. 单侧慢性化脓性中耳炎颞骨CT解剖学研究[J]. 中国临床解剖学杂志. 2022, 40(2): 164-167 https://doi.org/10.13418/j.issn.1001-165x.2022.2.09

Hu Ruili, Zhang Xiaochen, Zou Dianjun, Zhang Qingjun, Lin Yantao, Liang Zhandong. CT anatomical research of temporal bone in unilateral chronic otitis media [J]. Chinese Journal of Clinical Anatomy. 2022, 40(2): 164-167 https://doi.org/10.13418/j.issn.1001-165x.2022.2.09

中图分类号： R764.2

参考文献

[1] 王治强, 张庆泉. 中耳不张对听力的影响及早期治疗效果观察[J]. 中华耳科学杂志, 2015, 13(4): 698-699. DOI: 10.3969/j.issn.1672-2922.2015.04.032.
[2] 蔡小剑, 郑亿庆, 张志刚, 等. 上鼓室内陷袋中耳通气功能的分析[J]. 中华耳科学杂志, 2013, 11(1): 80-84. DOI: 10.3969/j.issn.1672-2922.2013.01.018.
[3] Iino Y, Imamura Y, Hiraishi M, et al. Mastoid pneumatization in children with congenital cholesteatoma: an aspect of the formation of open-type and closed-type cholesteatoma[J]. Laryngoscope, 1998, 108(7): 1071-1076. DOI: 10.1097/00005537-199807000-00022.
[4] Todd NW. Cranial anatomy and otitis media: a cadaver study[J]. Am J Otol, 1998, 19(5): 558-564. PMID: 9752960.
[5] 陆银萍, 刘平, 闫鑫. 慢性中耳炎患者双侧乳突气化程度不对称性分析[J]. 中国耳鼻咽喉头颈外科, 2020, 27(1): 1-3. DOI: 10.16066/j.1672-7002.2020.01.001.
[6] Paltura C, Can TS, Yilmaz BK, et al. Eustachian tube diameter: Is it associated with chronic otitis media development[J]? Am J Otolaryngol, 2017, 38(4): 414-416. DOI: 10.1016/j.amjoto.2017.03.012.
[7] Elif Gündoğdu, Uğur Toprak. Comparison of the aditus ad antrum diameter on CT between patients with chronic otitis media and healthy individuals[J]. Curr Med Imaging Rev, 2019, 15(10), 990-993. DOI: 10.2174/1573405615666190327110216.
[8] 闫晶晶, 梁勇, 陈燕萍, 等. 61例中耳炎咽鼓管多层螺旋CT影像解剖学研究[J]. 中国临床解剖学杂志, 2010, 28(1): 50-53. DOI: 10.13418/j.issn.1001-165x.2010.01.038.
[9] 张绍兴, 马芙蓉, 邬海博, 等. 颞骨解剖变异在慢性化脓性中耳发病机制中的意义[J]. 中国耳鼻咽喉头颈外科, 2012, 19(4): 182-185. DOI: 10.16066/j.1672-7002.2012.04.007.
[10] 中华医学会耳鼻咽喉科分会, 中华耳鼻咽喉头颈外科杂志编辑委员会. 中耳炎的分类和分型(2004年, 西安)[J]. 中华耳鼻咽喉头颈外科杂志, 2005, 40(1): 5. DOI: 10.3760/j.issn:1673-0860.2005.01.004.
[11] 王治强, 张庆泉. 中耳不张对听力的影响及早期治疗效果观察[J]. 中华耳科学杂志, 2015, 13(4): 698-699. DOI: 10.3969/j.issn.1672-2922.2015.04.032.
[12] Swarts JD, Alper CM, Luntz M, et a1. Panel 2: Eustachian tube, middle ear, and mastoid anatomy, physiology, pathophysiology and pathogenesis[J]. Otolaryngol Head Neck Surg, 2013, 148(4 Suppl): E26-E36. DOI: 10.1177/0194599812472631.
[13] Galhede M, Dirckx JJJ, Jacobsen H, et a1. Middle ear pressure regulation-complementary active actions of the mastoid and the Eustachian tube[J]. Otol Neurotol, 2010, 3l(4): 603-611. DOI: 10.1097/ MA0. 0b013e3181ddl3e2．
[14] Aksoy S, Sayin1 I, Yazici ZM etal. The evaluation of the angles of Eustachian tubes in the patients with chronic otitis media on the temporal computerized tomography[J]. Niger J Clin Pract, 2016: 19(3): 318-322. DOI: 10.4103/1119-3077.179274.