咽鼓管异常开放患者咽鼓管腔的三维计算机断层扫描成像

Three-dimensional computed tomography imaging of the eustachian tube lumen in patients with patulous eustachian tube.

作者信息

Kikuchi Toshiaki, Oshima Takeshi, Hori Yoko, Kawase Tetsuaki, Kobayashi Toshimitsu

机构信息

Department of Otolaryngology-Head and Neck Surgery, Tohoku University Graduate School of Medicine, Sendai, Japan.

出版信息

ORL J Otorhinolaryngol Relat Spec. 2009;71(6):312-6. doi: 10.1159/000265939. Epub 2009 Dec 17.

DOI:10.1159/000265939

PMID:20016242

Abstract

BACKGROUND

The eustachian tube (ET) has a complicated anatomy, which is related to middle ear pathology. The anatomy of the ET has been well investigated in cadavers, but may not accurately reflect that in living subjects. Three-dimensional (3D) computed tomography (CT) was used to examine the ET in patients with patulous ET.

METHOD

The subjects were 35 patients (17 males, aged 59 +/- 16 years, and 18 females, aged 44 +/- 15 years) with patulous ET which could be continuously traced from the pharyngeal orifice to the tympanic orifice (53 ears). CT was performed in the sitting position at rest, followed by 3D reconstruction. The course of the ET from the middle ear to the pharynx was visualized in 3D surface images. Morphological measurements of the curvature angle (angle C) and the inclination angle (angle I) were determined from 3D coordinates on the CT images.

RESULTS

The full length of the ET could be visualized in most patients suffering from patulous ET in the sitting position. Angle C was 21.7 +/- 5.8 degrees in the patients aged <40 years (n = 20), which is significantly larger than 16.7 +/- 6.8 degrees in the patients aged >59 years (n = 18; Student's t test, p < 0.05). Angle I was 26.5 +/- 4.2 degrees in the patients aged <40 years (n = 20), also significantly larger than 21.6 +/- 5.8 degrees in the patients aged >59 years (n = 18; Student's t test, p < 0.05).

CONCLUSION

CT in the sitting position is a potential diagnostic tool of the ET and middle ear pathology.

摘要

背景

咽鼓管（ET）解剖结构复杂，与中耳病变相关。ET的解剖结构在尸体上已得到充分研究，但可能无法准确反映活体的情况。本研究采用三维（3D）计算机断层扫描（CT）对咽鼓管异常开放患者的ET进行检查。

方法

研究对象为35例咽鼓管异常开放患者（17例男性，年龄59±16岁；18例女性，年龄44±15岁），共53耳，其咽鼓管可从咽口连续追踪至鼓口。患者静息坐位时行CT检查，随后进行三维重建。通过3D表面图像观察ET从中耳到咽部的走行。根据CT图像上的3D坐标确定曲率角（角C）和倾斜角（角I）的形态学测量值。

结果

大多数咽鼓管异常开放患者在坐位时可观察到ET的全长。年龄<40岁患者（n = 20）的角C为21.7±5.8度，显著大于年龄>59岁患者（n = 18）的16.7±6.8度（Student t检验，p < 0.05）。年龄<40岁患者（n = 20）的角I为26.5±4.2度，也显著大于年龄>59岁患者（n = 18）的21.6±5.8度（Student t检验，p < 0.05）。