“两线相交”法在侧颅钻孔引流术前定位钻孔窗的可行性和有效性

Feasibility and effectiveness of the"two-line intersection"approach in determining the burRhole before lateral cranial burr hole drainage

目的探讨“两线相交”法在侧颅钻孔引流术前定位钻孔窗的可行性、有效性。方法选取20例因头晕、头痛等原因做颅脑CT检查的志愿者,CT检查前,在侧颅随机选取一个点,将回形针置于头发根部并最大限度接近皮肤,回形针的长轴与耳廓前缘平行,使用皮尺手工测量回形针内小U形结构底部至外眦(孔眦径)、耳屏前缘根部(孔耳径)的距离;CT检查后,在后处理工作站测量孔眦径、孔耳径。验证方法:根据后处理工作站测量值制作相应长度的两根棉签,将两根棉签拿到志愿者侧颅获取颅上区的交点,计算交点与模拟钻孔窗的偏离。结果手工皮尺测量孔眦径8.20~11.20 cm,平均(9.36±0.86)cm;CT测量孔眦径8.10~11.40 cm,平均(9.39±0.90)cm;两者无统计学差异(P=0.516)。手工皮尺测量孔耳径7.30~9.30 cm,平均(8.50±0.53)cm;CT测量孔耳径7.60~9.40 cm,平均(8.51±0.51)cm;两者无统计学差异(P=0.920)。验证结果:两棉签交点与实际模拟钻孔窗的偏离0~0.40 cm,平均(0.18±0.11)cm。结论利用“两线相交”定位侧颅钻孔窗便捷、准确,可为临床提供参考。

Objective To investigate the feasibility and effectiveness of the"two-line intersection"approach in determining the burRhole before lateral cranial burRhole drainage.Methods Twenty volunteers with symptoms such as dizziness and headache were selected foRcranial CT examinations.PrioRto the CT examination,a random point was chosen on the lateral skull,and a papeRclip was placed at the haiRroot and as close to the skin as possible;then the distances from the bottom of the small U-shaped structure in the papeRclip to the outeRcanthus(hole-canthus diameter)and the leading edge of the tragus(hole-eaRdiameter)were measured manually using a tape measure.AfteRthe CT examination,the diameters of the hole-canthus and the hole-eaRwere measured at the postprocessing workstation.Verification method:Two cotton swabs of corresponding lengths were fabricated based on the measured values at the post-processing workstation;the two cotton swabs were then applied to the lateral cranial area of the volunteers to obtain the intersection point of the superioRcranial area,and the deviation between this intersection point and the simulated drilling window was calculated.Results The diameteRof the hole-canthus measured by manual tape ranged from 8.20 to 11.20 cm,with an average of(9.36±0.86)cm;the diameteRof the hole-canthus measured by CT system ranged from 8.10 to 11.40 cm,with an average of(9.39±0.90)cm;there was no significant difference in the diameteRof the hole-canthus measured by the manual tape and the CT system(P=0.516).The hole-eaRdiameteRmeasured by manual tape ranged from 7.30 to 9.30 cm,with an average of(8.50±0.53)cm;the diameteRof the holeeaRmeasured by CT system ranged from 7.60 to 9.40 cm,with an average of(8.51±0.51)cm;there was no significant difference in the diameteRof the hole-eaRmeasured by the manual tape and the CT system(P=0.920).Verification results:The deviation between the intersection point of the two cotton swabs and the actual simulated drilling window ranged from 0 to 0.40 cm,with an average of(0.18±0.11)cm.Conclusion The application of the"two-line intersection"foRlocating the lateral cranial drilling window is convenient and accurate,and can provide a reference foRclinical practice.