颞骨解剖变异在慢性化脓性中耳炎发病机制中的意义

Significance of the morphometric measurements from temporal CT in chronic otitis media disease

目的研究慢性化脓性中耳炎患者的颞骨CT解剖参数变化,探讨颞骨解剖变异在慢性化脓性中耳炎发病机制中的意义。方法回顾性分析100例单侧非胆脂瘤型慢性化脓性中耳炎患者(病例组)与37例正常对照者(对照组)的颞骨CT,对咽鼓管外耳道角(auditory tube angle,ATA)、岩枕角(petroclival angle,PCA)、乳突气房面积(mastoid aera,MA)、外耳道上棘乙状窦间距离(henle spine and SS,H-SS)解剖参数进行测量。结果①病例组患侧ATA、MA、H-SS分别是150.13±5.76,190.89±152.61,11.61±3.41,病例组非患侧ATA、MA、H-SS分别是151.33±5.49、336.45±175.22、12.69±3.43。对照组ATA、MA、H-SS分别是148.57±4.38、470.13±170.47、12.81±3.49。②组间比较,病例组患侧与对照组ATA、MA、H-SS差异均具有统计学意义(P<0.05),病例组非患侧与对照组ATA、MA、H-SS差异均具有统计学意义(P<0.05)。组内比较,病例组的患病侧与非患侧MA、H-SS差异均具有统计学意义(P<0.05)。③在对照组中,ATA与PCA、ATA与H-SS,PCA与MA、PCA与H-SS均具有低度相关性。病例组与对照组中,H-SS与MA具有显著相关性。结论颞骨解剖参数之间相互关联、影响。颞骨解剖变异,较大的ATA,较小的乳突与慢性化脓性中耳炎相关。各解剖参数间关系失衡是慢性化脓性中耳炎的解剖特点之一。

OBJECTIVE To determine whether a relationship exists in Chinese people between auditory tube angle（ATA）,petroclival angle（PCA）,mastoid air cells aera（MA）and henle spine and sigmoid sinus（H-SS）and chronic ear disease,and their association with each other.METHODS A radiological and clinical study was carried out on the temporal bones of 137 subjects.There were 100 patients with unilateral chronic otitis media（disease group）and 37 healthy controls（control group）,the contralateral healthy ears of the patients were also used as control group（healthy side from disease group）.From each CT scan the distance,angle and aera was assessed.RESULTS There was significant difference in the ATA、MA、H-SS results between control group and disease group,and between control group and healthy side from disease group（P 0.05）,MA and H-SS were significantly different between disease group and healthy side from disease group（P 0.05）.An significant correlation between H-SS and MA in both healthy and diseased ears was observed（r=0.695,r=0.538,r=0.602,P 0.01）,correlations between ATA and PCA、ATA and H-SS,PCA and MA、PCA and H-SS in control group were low.CONCLUSlON The morphometric measurements from temporal CT were associated with and influenced by each other.Temporal bone anatomic abnormality,more obtusely angled ATA,smaller MA and H-SS were correlative with chronic ear disease.Chronic otitis media was characterized by the imbalance of relations among different parts.