维吾尔族中耳炎患者颞骨薄层CT特征分析

Clinical analysis of temporal bone HRCT of the Uyghur patients with otitis media

目的分析中耳炎患者的颞骨薄层CT情况,总结维吾尔族中耳炎患者颞骨解剖变异的规律。方法回顾性分析704例慢性化脓性中耳炎住院患者和203例正常对照组的颞骨薄层冠状面、横断面高分辨率CT(high resolution CT,HRCT),并对其颞骨的气化程度、乙状窦前置、颈静脉球高位、脑板低位进行比较;包括中耳炎组与对照组、民族之间、胆脂瘤型中耳炎与非胆脂瘤型中耳炎及胆脂瘤型中耳炎中各民族之间的比较。结果中耳炎组与对照组患者颞骨气化程度、乙状窦前置、脑板低位比较,差异具有统计学意义(P<0.05);中耳炎组中维族组与汉族组气化程度、乙状窦前置、颈静脉球高位及脑板低位比较,差异具有统计学意义(P<0.05);胆脂瘤型与非胆脂瘤型中耳炎颞骨解剖变异比较,仅气化不良差异具有统计学意义(P<0.05);胆脂瘤型中耳炎中各民族组比较,仅乙状窦前置差异具有统计学意义(P<0.05)。结论维吾尔族中耳炎患者的颞骨变异具有其规律,研究该规律有助于手术入路设计、术中重要结构的定位和保护。

Objective To analyze the HRCT features of temporal bone in Uygur patients with otitis media, and summarize the regularity of temporal bone anatomic variances in Uighurs. Methods Clinical data and HRCT （both axial and coronal planes ） features from 704 patients with chronic suppurative otitis media and 203 healthy adults were analyzed retrospectively. HRCT features including pneumatization of temporal bone, far-advanced sigmoid sinus, high jugular bulb and low brain board were evaluated in both groups. The above-mentioned indexes were compared between the otitis media group and the control group, groups of Uygur and Han nationality, cholesteatoma and non-cholesteatoma subgroups in otitis media group, national subgroups in cholesteatoma otitis media group. Results The differences of pneumatization of temporal bone, far-advanced sigmoid sinus, and low brain board between the otitis media group and the control group were statistically significant （ P 〈 0.05 ） . Those between Han and Uighur subgroups in otitis media group were also statistically significant （ P 〈 0. 05 ）. In cholesteatoma otitis media group, the differences of far-advanced sigmoid sinus were statistically significant among national subgroups （ P 〈 0. 05 ）. Conclusions The anatomic variances of pneumatization of temporal bone, far-advanced sigmoid sinus, high jugular bulb and low brain board in Uighurs with chronic suppurative otitis media possess regularity, which might facilitate the imaging diagnosis, preoperative design of the surgical approach, intraoperative position and protection of vital structures in otoneurosurgical procedures and lateral cranial base surgery.