摘要
目的评估成人中耳乳突炎(OM)侧颞骨内永存岩鳞窦(PSS)的发生情况,探讨PSS与颞骨气化(TBP)程度的关系。方法回顾性纳入2018年9月至2018年12月于首都医科大学附属北京友谊医院行颞骨高分辨率CT(HRCT)检查并诊断为OM的患者245例/376侧,包括单纯慢性OM组191例/315侧,OM合并中耳胆脂瘤组35例/39侧,急性OM组19例/22侧;纳入行眼部或鼻部HRCT检查且双侧颞骨未见异常者346例(692侧)为对照组。基于0. 67mm标准横断面、冠状面观察PSS相关征象,测量其平均直径。基于乙状窦沟将TBP分为Ⅰ~Ⅳ级,分别比较不同类型OM组及对照组间、不同气化程度组间PSS发生率的差异。结果 PSS在单纯慢性OM组、OM并中耳胆脂瘤组、急性OM组、对照组中发生率分别为34. 3%、43. 6%、13. 6%、10. 1%,管径2 mm以上者分别为6. 3%、7. 7%、0%、0. 9%。单纯慢性OM组、OM并中耳胆脂瘤组分别较急性OM组及对照组PSS发生率高,差异具有统计学意义(P <0. 05)。单纯慢性OM组、OM并中耳胆脂瘤组TBP为Ⅰ级或Ⅱ级者分别占79. 7%、92. 3%。按照颞骨气化程度分组,Ⅰ、Ⅱ、Ⅲ、Ⅳ级组内PSS发生率分别为36. 1%、41. 5%、18. 4%、10. 7%,Ⅰ级组与Ⅱ级组间差异无统计学意义,其余各组间差异均具有统计学意义(P <0. 05)。结论 PSS的发生率与TBP程度密切相关,慢性OM者因颞骨多气化较差而更常见粗大PSS,术中需重点观察避免医源性损伤。
Objective To evaluate the prevalence of persistent petrosquamosal sinus( PSS) in adult patients with otitis media( OM) and to explore the relationship between PSS and the degree of temporal bone pneumatization( TBP). Methods Two hundred and forty five patients( 376 sides) who underwent temporal bone HRCT since September to December of 2018 in Beijing Friendship hospital diagnosed with OM were included the present study retrospectively,including 191 cases/315 sides in simple chronic OM group,35 cases/39 sides in OM combined with middle ear cholesteatoma group,19 cases/22 sides in acute OM group. Three hundred and forty-six patients( 692 sides) who underwent orbital or sinonasal HRCT with no abnormalities in bilateral temporal bones were included as the control group. The signs of PSS were observed based on the 0. 67 mm standard axial and coronal images,and the mean diameter was measured. The degree of TBP was divided into Ⅰ-Ⅳ based on the sigmoid sinus sulcus. The difference in the prevalence of PSS between different types of OM group and control group as well as between different TBP degree groups was compared respectively. Results The prevalence of PSS in the simple chronic OM group,OM with middle ear cholesteatoma group,acute OM group and control group was about 34. 3%,43. 6%,13. 6%,10. 1%,and the diameter more than 2 mm PSS accounted for 6. 3%,7. 7%,0%,0. 9%,respectively. The PSS was more commonly seen in the chronic OM group or OM with middle ear cholesteatoma group than that in the acute OM group or the control group and the differences in the prevalence of PSS were significant( P < 0. 05). TBP as Grade Ⅰ or Ⅱ accounted for 79. 7% and 92. 3% in simple chronic OM group and OM with middle ear cholesteatoma group,respectively. The prevalence of PSS in the Ⅰ,Ⅱ,Ⅲ,and Ⅳ groups of TBP was about 36. 1%,41. 5%,18. 4%,and 10. 7%,respectively. The difference was significant between any two groups except between the Ⅰ and Ⅱ groups( P < 0. 05). Conclusion The prevalence of PSS is closely related to th
作者
赵鹏飞
王振常
吕晗
丁贺宇
管琳娜
李丽
窦瑞芳
孟续续
代驰航
杨正汉
ZHAO Peng-fei;WANG Zhen-chang;LV Han(Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China)
出处
《临床和实验医学杂志》
2019年第14期1492-1495,共4页
Journal of Clinical and Experimental Medicine
基金
国家自然科学基金(编号:61527807,81701644)
北京市人社局(编号:京人社专家发〔2015〕160号)
北京市自然科学基金(编号:7172064)
北京市医管局(编号:SML20150101)
关键词
永存岩鳞窦
颞骨
中耳乳突炎
气化
高分辨率CT
Petrosquamosal sinus
Temporal bone
Otitis media
Pneumatization
X ray Computed Tomography
