单侧慢性化脓性中耳炎颞骨CT解剖学研究

CT anatomical research of temporal bone in unilateral chronic otitis media

目的研究单侧慢性化脓性中耳炎颞骨CT解剖学特征及其临床意义。方法回顾性分析35例单侧非胆脂瘤型慢性化脓性中耳炎患侧颞骨(病例组)与健侧颞骨(对照组)CT影像资料,比较两组咽鼓管外耳道角、岩枕角、乳突窦入口直径、咽鼓管骨部直径、咽鼓管骨部长度、咽鼓管骨部最大径与咽鼓管骨部长度之比,及乳突气化程度(良好、差)等解剖参数。结果患侧咽鼓管外耳道角、岩枕角分别是(137.4±8.1)°、(52.5±3.8)°,乳突窦入口直径、咽鼓管骨部最大径分别是(0.29±0.08)cm、(0.18±0.07)cm,咽鼓管骨部长度为(1.07±0.15)cm,咽鼓管骨部最大径与骨部长度之比为(17.1±5.4)%;健侧咽鼓管外耳道角、岩枕角分别是(138.3±7.7)°、(53.1±4.3)°,乳突窦入口直径、咽鼓管骨部最大径分别是(0.35±0.07)cm、(0.21±0.07)cm,咽鼓管骨部长度为(1.17±0.17)cm,骨部最大径与骨部长度之比为(20.9±14.3)%。患侧乳突窦入口直径、咽鼓管骨部最大径、咽鼓管骨部长度较健侧小,差异具有统计学意义(t=4.37、3.09、-3.17,P<0.05)。患侧乳突气化较健侧差,差异具有统计学意义(χ^(2)=6.34,P<0.05)。患侧与健侧咽鼓管外耳道角、岩枕角及咽鼓管骨部最大径与咽鼓管骨部长度之比差异无统计学意义(P>0.05)。结论单侧慢性化脓性中耳炎患侧颞骨存在解剖变异。咽鼓管骨部小、乳突气化差及乳突窦入口狭窄与单侧慢性化脓性中耳炎相关。

Objective To study the CT anatomical features and the clinical significance of temporal bone in unilateral chronic otitis media(COM).Methods The CT images of 35 patients with unilateral COM on the affected side(an experimental group)and the healthy side(a control group)of temporal bone were analyzed retrospectively.Auditory tube angle(ATA),petroclival angle(PCA),diameter of aditus mastoid(DA),diameter(D)and length(L)of osseous segments of Eustachian Tube,the ratio of maximum diameter and length(D/L)of osseous segments of Eustachian Tube and mastoid pneumatization of the two groups were compared.Results In the experimental group,the ATA and the PCA of were(137.4±8.1)°,(52.5±3.8)°,respectively,DA and D were(0.29±0.08)cm,(0.18±0.07)cm,respectively,L was(1.07±0.15)cm and D/L was(17.1±5.4)%.In the control group,the ATA and the PCA of were(138.3±7.7)°,(53.1±4.3)°,respectively,DA and D were(0.35±0.07)cm,(0.21±0.07)cm,respectively,L was(1.17±0.17)cm and D/L was(20.9±14.3)%.There was significant difference in the result of DA,D and L of osseous segments of Eustachian Tube and mastoid pneumatization between experimental group and control group(t/χ^(2)=4.37,3.09,-3.17,6.34,P<0.05).There was no significant difference in the result of ATA,PCA,D/L between experimental group and control group(P>0.05).Conclusions There is anatomic variation in the temporal bone of patients with unilateral chronic suppurative otitis media.The small osseous segments of Eustachian Tube,narrow entrance of aditus mastoid and poor mastoid pneumatization are associated with unilateral COM.