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目的探讨先天性外耳道闭锁症患者的面神经水平段遮窗;垂直段前移的临床标准。方法采用多平面技术分别对40例正常者和40例先天性外耳道闭锁症患者进行面神经管的测量。冠状位测量前庭窗下缘与面神经水平段的垂直距离(以下称AB距离);斜矢状位测量上半规管与水平半规管交角作垂直线,测量该线与乳突段的垂直距离(以下称EF距离)。结果先天性外耳道闭锁症患者的AB距离≤0.4mm时,面神经水平段为严重遮窗,EF距离≤5mm时为面神经乳突段前移。先天性外耳道闭锁症患者和正常人的AB与EF距离比较具有统计学意义(P<0.01)。结论首次制定了国人中耳面神经畸形的测量值,通过多平面技术使耳显微外科医生能准确地判断中耳高危险区的解剖标志。
Objective To explore the clinical criteria for the masking of the facial nerve in patients with congenital external auditory canal atresia. Methods Multiplanar technique was used to measure facial nerve canal in 40 normal subjects and 40 patients with congenital external auditory canal obstruction. Coronal measurement of the vertical distance between the lower edge of the vestibular window and facial nerve horizontal section (hereinafter referred to as AB distance); oblique sagittal measurement of the semicircular canal and semicircular canal perpendicular to the vertical line, measuring the line and mastoid distance (hereinafter EF distance). Results When the AB distance ≤0.4mm in patients with congenital external auditory canal atresia, the level of facial nerve was severely obscured, and when the distance of EF ≤5mm, facial segment was advanced. The distance between AB and EF in patients with congenital external auditory canal obstruction and normal persons was statistically significant (P <0.01). Conclusion For the first time, the measurement of middle ear facial deformity in Chinese people has been made. By means of multiplanar technique, ear microsurgery can accurately determine the anatomical landmarks in high risk area of middle ear.