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目的通过多层螺旋CT多平面重组重建了解中耳炎耳咽鼓管与正常耳咽鼓管的解剖关系,为临床研究提供解剖学资料。方法设61例(85耳)中耳炎患者为病变组,设鼓膜完整的15例(30耳)经专科检查、纯音测听及声导抗检查排除中耳病变且咽鼓管功能正常者作为对照组,两组均采用多层螺旋CT分别行颞骨静态及动态CT扫描,且均行多平面重组重建,重建后分别测量其骨部、软骨部开放区域、软骨部闭合区域、软骨部有效闭合区域长度,并比较两组间的影像学差异。结果对照组鼓室前段直径(9.95±1.29)mm,骨-软骨接合部直径(3.89±0.50)mm,骨部长度(20.89±1.81)mm;病变组鼓室前段直径(9.85±0.83)mm,骨-软骨接合部直径(3.92±0.37)mm,骨部长度(20.51±2.13)mm;静态CT多平面重组重建:对照组开放区域长度(10.99±0.87)mm,闭合区域长度(36.90±6.73)mm,病变组开放区域长度(8.50±0.55)mm,闭合区域长度(42.26±7.19)mm;动态CT多平面重组重建:对照组有效闭合区域长度(10.20±3.96)mm,病变组有效闭合区域长度(33.32±9.44)mm。结论中耳炎耳咽鼓管与正常耳咽鼓管骨部无明显差异;静态下病变组软骨部闭合区域大于对照组软骨部闭合区域长度;动态下对照组咽鼓管软骨部闭合区域长度减小,开放区域长度增加,而病变组闭合区域长度改变不明显。
OBJECTIVE: To dissect the relationship between otitis media and normal eustachian tube by multi-slice spiral CT reconstruction and to provide anatomical data for clinical research. Methods Totally 61 patients (85 ears) with otitis media were selected as the lesion group. Fifteen patients (30 ears) with complete tympanic membrane were selected as the control group by specialist examination, pure tone audiometry and acoustic conductivity test to exclude the middle ear lesions and the eustachian tube function. , Respectively. Both groups were subjected to static and dynamic CT scans of the temporal bone by multi-slice spiral CT, and were reconstructed by multiplanar reconstructions. After reconstruction, the open area of the cartilage, the cartilaginous closed area, the effective closed area of cartilage , And compared the imaging differences between the two groups. Results The diameter of the anterior tympanic segment was (9.95 ± 1.29) mm in the control group, 3.89 ± 0.50 mm in the bone-cartilage junction, and 20.89 ± 1.81 mm in the anterior tympanic segment. The diameter of the anterior tympanic segment in the lesion group was 9.85 ± 0.83 mm, The diameter of the cartilaginous junction was 3.92 ± 0.37 mm and the length of the bone was 20.51 ± 2.13 mm. The static CT multiplanar reconstructions showed that the opening length of the control group was (10.99 ± 0.87) mm, the length of the closing area was (36.90 ± 6.73) mm, The length of the open area of the diseased group was (8.50 ± 0.55) mm and the length of the closed area was (42.26 ± 7.19) mm. The dynamic multi-plane reconstructed CT reconstruction showed that the length of the effective closed area was 10.20 ± 3.96 mm in the control group and 33.32 ± 9.44) mm. Conclusions There is no significant difference between otitis media and normal eustachym tube in otitis media group. The closed area of cartilaginous area in the diseased group is larger than that in the control group. The closed area of eustachian tube in the control group is reduced, The length of the open area increased, but the length of the closed area of the lesion changed insignificantly.