高分辨CT在中耳乳突术后病变诊断中的应用

High resolution computer tomography in evaluation of problematic mastoidectomy cavities following chronic otitis media

目的 探讨在慢性化脓性中耳炎中耳乳突术后,高分辨CT在中耳乳突病变及中耳乳突结构诊断中的应用。方法:回顾性分析了65例因慢性中耳炎中耳乳突术后复发性病变行再次手术患者的高分辨CT结果,将CT结果与手术所见进行对比分析。结果 高分辨CT可诊断中耳乳突腔内复发病变的们置和范围;并能确定面神经、半规管骨管的完整性,其诊断准确性与手术所见有较好的诊断符合率;也能较好的判断锤骨、砧骨的完整性。结论高分辩CT可准确的诊断中耳乳突手术后复发、残留病变的位置和范围,并能明确面神经、半规管等重要结构的完整性以及可能的解剖变异,而这些信息不可能单从临床检查中发现,因此对于中耳乳突手术后需要再手术的患者应常规进行高分辨CT检查。

OBJECTIVE: to determine the reliability of high - resolution computer tomography for the diagnosis of problematic cavities following mastiodectomy for chronic otitis media. PATIENTS AND METHODS: sixty - five patients who suffered from problematic mastoid cavities after tympanomastiodectomy operations were involved in this retropective study. All of the patients were examined by high resolution computer tomography of the temporal bone followed by surgical reexploration of the middle ear and mastoid. CT findings were analyzed and correlated with surgical findings. RESULTS: HRCT could detect the site and extent of the disease tissue in the temporal bone and predict the integrity of the facial never canal and lateral semicircular canal wall; the results of HRCT had a good correlation with the operative findings HRCT was also good at predicton of ossicular condition except stapes. CONCLUSIONS: HRCT can provide informations regarding the nature and extent of recurrent or residual disease of the surgically altered mastoid cavities as well as possible anatomic varations, which may not be apparent on the basis of the clinical findings alone. Our results suggest that HRCT scanning should be performed on all patients who presenting with problematic cavities after tympanoinastoid surgery for chronic otitis media.