圆窗区颞骨切片和CT对照观察

Round window area temporal bone section versus CT

目的 明确圆窗区及其相关结构在耳的横断薄层和在CT上的定位及毗邻关系 ,为该区域病变的影像诊断和手术治疗提供解剖学参考。方法 外观无异常的经 10 %甲醛固定的成人头颅标本 15例 (30侧 ) ,以眦耳线为基线 ,用高分辨率CT扫描 ,获得间隔为 1 0 0mm ,厚度为 1 0 0mm的CT图像 ,扫描后的颅脑标本按原定位截取以耳颞区为中心的组织块 ,常规脱钙、脱水、火棉胶浸胶 ,包埋并按标记切制成厚为 1 0 0mm的连续横断薄层切片 ,肉眼和手术显微镜下观察切片的下表面并扫描照相。标本切片与CT图像对照 ,逐一辨识颞骨内听小骨、骨性半规管、前庭、圆窗、圆窗龛、耳蜗、锥隆起、内耳道、耳蜗水管等结构。结果 颞骨横断CT扫描 ,有 18～ 2 2个层面 ,圆窗和圆窗龛出现层面多为第 10层 (右侧 )和第 11层 (左侧 ) ,圆窗龛前壁厚度平均为右侧 0 92mm和左侧 0 90mm ,龛深平均为右侧 1 89mm和左侧 2 0 4mm ,龛与颈静脉窝间骨壁的平均距离为右侧 2 10mm和左侧 2 39mm。龛前壁厚度、龛深、龛与颈静脉窝骨壁的距离左、右侧差异无显著性 (P >0 0 5 )。结论 耳颞区火棉胶薄层断面标本能良好显示圆窗区及其周围结构的解剖位置和毗邻关系 ,可直接与高分辨率CT扫描图像进行对照研究 ,其结果对耳科疾病的影像诊断及手术治疗有?

Objective To locate round window area and its related structure on auris transection and CT for anatomical evidence of image diagnosis and clinical operation. Methods Fifteen normal head specimen fixed with 10% dehycle were scanned by high-resolution computed tomography on canthomeatal line. CT image (depth 1.00 mm, thick 1.00 mm) was obtained. Temporal bone-centered tissues were taken, decalcified, desiccated and socked with collodion, then embedded and made into sequential transactions (thick 1.00 mm). Lower surface of section was observed by both naked eyes and microscope, then scanned and photographed. Versus CT image, auditory ossicle, osseous semicircular canals, vestibule, round window, niche, cochlea, pyramidal eminence, internal acoustic meatus and cochlear aqueduct were identified respectively. Results There were 18-22 layers of temporal transection on CT image. Round window and round window niche always appeared on the 10th layer (R) and the 11th layer (L). The mean of the depth of anterior wall was 0.92 mm (R) and 0.90 mm (L), and depth 1.89 mm (R) and 2.04 mm (L). The average distance from niche to jugular fossa wall was 2.10 mm (R) and 2.39 mm (L). No significant difference among of thickness, depth and distance from niche to jugular fossa wall. Conclusions Temporal bone transection specimen had a clear picture of anatomical position between round window area and its related structure. Versus CT, the result contributed to image diagnosis and operation on auris diseases.