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目的用多层螺旋CT(MSCT)曲面重建(CPR)技术研究先天性外耳道闭锁中面神经管的异常。方法对15例(17耳)先天性外耳道闭锁患者进行多层螺旋高分辨率CT(HRCT)扫描,图像后处理在Philips Mx8000工作站进行。结果17耳中,外耳道狭窄2耳,外耳道膜性闭锁2耳,骨性闭锁13耳。外耳道先天性胆脂瘤及耳后瘘管1耳。鼓室畸形3耳。听小骨先天畸形7耳。内耳畸形1耳。面神经管异常17耳。其中面神经管总长度变短11耳,面神经管走行异常5耳,面神经管位置异常9耳,面神经管管径变细1耳,面神经管分叉1耳。结论MSCT高分辨率扫描加CPR技术能清晰显示先天性外耳道闭锁患者中面神经管的异常,有利于临床医生术前详尽了解面神经管的行程,减少不必要的面神经意外损伤。
Objective To study the abnormalities of the facial neural tube in the congenital external auditory canal atresia by multi-slice spiral CT (MSCT) surface reconstruction (CPR). Methods Fifteen patients (17 ears) with congenital external auditory canal atresia were scanned by multi-slice spiral CT (HRCT). The image post-processing was performed on the Philips Mx8000 workstation. Results 17 ears, 2 ears of external auditory canal stenosis, 2 ears of membranous atresia of external auditory canal, 13 ears of bony atresia. External auditory canal cholesteatoma and ear after ear fistula 1 ear. Tympanic malformation 3 ears. Listen to the small bone congenital malformations 7 ears. Inner ear deformity 1 ear. Facial nerve tube abnormalities 17 ears. Among them, the total length of the facial nerve canal shortens 11 ears, the facial nerve canal runs abnormally 5 ears, the facial nerve tube abnormalities 9 ears, the facial nerve canal diameter becomes 1 ear, the facial nerve canal branches 1 ear. Conclusion MSCT high resolution scanning and CPR can clearly show the abnormality of facial nerve canal in patients with congenital external auditory canal obstruction. It is of help for clinicians to fully understand the facial nerve tube stroke before surgery and reduce the unnecessary facial nerve injury.