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目的:采用SIEMENS SOMATOM Sensation 64层螺旋CT行颞骨高分辨扫描,探讨先天性外中耳畸形(CAEMA)面神经走形的特点,以利于术前评估。方法:选取2005-11-2007-03期间中山大学附属第二医院耳鼻咽喉科住院诊断为先天性外中耳畸形的29例(35耳)患者为研究对象,以畸形耳为研究组,其中单侧畸形23例(23耳,其中右耳13例,左耳10例),双侧畸形6例(12耳)。对照组为研究组中单侧畸形之健耳23例(23耳)。采用Takegosh以直角坐标系描述面神经走行的方法,借助高分辨率CT重建功能,于高分辨率CT上取3个层面获得面神经位置,描述面神经的走形。结果:研究组35耳,单侧畸形23耳,双侧畸形12耳,对照组23耳,CAEME面神经鼓室段与前庭窗的最短距离较正常组变短(P<0.05);单侧CAEME面神经乳突段较正常组前移约2.7mm,双侧CAEME面神经乳突段较正常组前移约3.0mm,单双侧畸形组统计学分析示差异无统计学意义(P<0.05);耳廓畸形程度与面神经乳突段前移有关(P<0.05)。结论:先天性外中耳畸形无论单侧还是双侧,面神经乳突段较正常耳前移;耳廓畸形程度与面神经乳突段前移有关;面神经外侧移位并不常见;面神经鼓室段与前庭窗距离变短。
OBJECTIVE: To investigate the characteristics of facial nerve deformity (CAEMA) by using SIEMENS SOMATOM Sensation 64-slice spiral CT in the temporal bone to facilitate the preoperative evaluation. Methods: Twenty-nine patients (35 ears) diagnosed as otorhinolaryngeal deformity in otolaryngology department of the Second Affiliated Hospital of Sun Yat-sen University from 2005 to 2007 were selected as the research object. Side deformities in 23 cases (23 ears, including 13 cases of right ear, 10 cases of left ear), bilateral deformity in 6 cases (12 ears). The control group was 23 cases (23 ears) of unilateral ear deformities in the study group. Using Takegosh’s method of describing the facial nerve in a Cartesian coordinate system, facial nerve position was obtained on 3 high-resolution CT scans using high-resolution CT reconstruction to describe facial nerve walking. Results: The shortest distance between the CAEME facial vestibular segment and the vestibular window in study group was shorter than that in the normal group (P <0.05). The unilateral CAEME Facial Nerve The anterior segment of the CAEME facial segment was about 2.7 mm forward and the bilateral CAEME facial segment was about 3.0 mm forward. The statistical analysis showed no significant difference (P <0.05). The auricular deformity The degree was related to the foregut transition of facial nerve milk (P <0.05). CONCLUSIONS: Congenital external middle ear deformity is superior to normal ear both unilateral and bilateral, and the degree of auricular deformity is related to the anterior facial degeneration of facial nerve. Facial laterals shift is not common. Shorten the distance of the vestibule.