摘要
目的：应用cT影像资料研究外耳道闭锁组与狭窄组之间颞骨发育程度的差异及面神经垂直段位置的变异特征。方法：收集71例先天性外中耳畸形142侧颞骨CT影像资料。按照外耳道骨性段最宽处直径大小分为外耳道闭锁组、狭窄组和正常的对侧耳为对照组。比较3组颞骨Jahrsdoerfer（Js）评分值、面神经垂直段位置及乳突气房容积等的差异。结果：耳道闭锁组的颞骨Js评分为7．26±2．02，耳道狭窄组为8．92±1．02，耳道正常组为10±0。3组间比较差异有统计学意义（P〈0．05）。在面神经垂直段起点层面，闭锁组、狭窄组分别与正常组比较，面神经向前、向外移位明显，差异有统计学意义（P〈0．05）；在面神经垂直段终点层面，闭锁组与正常组比较，垂直段面神经向前、外移位明显，差异有统计学意义（P〈0．05），狭窄组与对照组、闭锁组与狭窄组相比，其差异无统计学意义（P〉0．05）。3组间乳突气房容积比较，差异无统计学意义（P〉0．05）。闭锁组和狭窄组内的Js评分与乳突气房容积、乳突气房容积与面神经至棘孔和乳突距离、Js评分与面神经至棘孔距离间关系，均成正相关。结论：颞骨总体发育情况与外耳道的发育基本一致，闭锁组Js评分最低，其颞骨发育相对最差。畸形外耳道（闭锁或狭窄）相对于正常外耳道而言，面神经垂直段位置变化较大，其前移、外移程度与颞骨发育情况、乳突气化大小密切相关。
Objective ： To report the anatomic variants of temporal bone and position change of the verti cal facial nerve on computed tomography （CT） in congenital aural atresia （CAA） , external auditory canal ste nosis （EACS）. Methods：Temporal bone high resolution CT data of 71 patients with congenital atresia or steno sis between 2008 and 2012 was enrolled in this study. According to the external auditory canal development and diameter, the patients were divided into three groups, the atresia group, stenosis group and control group. Ana tomic variants including Jahrsdoerfer （Js） grading system, the mastoid cell volume, the position change of ver tical facial nerve （ anterior and lateral displacement） were studied. Results ： The average Js scores of atresia group, stenosis group and normal group were 7.26± 2.02, 8.92 ±l. 02 and 10 ± 0, respectively. There were significant differences among the three groups. The superior end of the vertical segment of the facial nerve dis placed anteriorly and laterally （ Atresia VS Stenosis, Stenosis VS Control, P 〈 0.05 ）. The inferior end of the vertical segment of the facial nerve displaced anteriorly and laterally （Atresia VS Control, P 〈 0.05 ）. There were no significant differences for the mastoid cell volume among the three groups. There were positive correla tion among Js grading scores, mastoid cell volume and the position change of the vertical facial nerve （ anterior and lateral displacement）. Conclusions ：Temporal bone development is in accordance with external auditory ca nal growth, while the temporal bone development of the atresia group is the worst. The position of the verticalsegment of facial nerve changes significantly in patients with malformed auditory canal, and is closely related to the mastoid cell volume and the temporal bone development.
出处
《解剖与临床》
2013年第2期109-113,共5页
Anatomy and Clinics
基金
上海市卫生系统新百人计划（编号XBR2011068）
