Doyle William J, Swarts J Douglas
Dept. of Otolaryngology, University of Pittsburgh, School of Medicine, Pittsburgh, PA 15213, USA.
Int J Pediatr Otorhinolaryngol. 2010 Sep;74(9):986-90. doi: 10.1016/j.ijporl.2010.05.021. Epub 2010 Jun 30.
The vector relationships between the Eustachian tube, Tensor veli palatini muscle and cranial base constrain the efficiency of middle ear pressure-regulation and are required parameters for computational modeling of Eustachian tube function. Here, those relationships were reconstructed from skulls and compared between children and adults.
Reconstructions were made using modifications of previously described techniques for 18 child skulls aged 3-4 years and 20 adult skulls (10 females, 10 males; >18 years). Measured and calculated variables were compared between groups using a Student's t-test.
Consistent with previous reports, certain variables for adult skulls exhibited sexual dimorphism. Between children and adults, significant differences were documented for measures of cranial base length and width; hard palate width; nasopharyngeal height, width and depth; Eustachian tube length; the maximum and minimum Tensor veli palatini muscle lengths; the angles of deviation of the Tensor veli palatini muscle from the Eustachian tube, and the surface area of the Tensor veli palatini muscle. There were no between-group differences in the angle of Eustachian tube decent from the cranial base, Eustachian tube deviation from the parasagittal plane or the lateral component of the Tensor veli palatine muscle-Eustachian tube angle.
The differences between children and adults that could account for the observed poorer Eustachian tube function in children include their shorter Eustachian tube, lesser Tensor veli palatine muscle-Eustachian tube vectors, and the lesser Tensor veli palatine muscle surface area. Other observed differences are attributable to growth and development of the craniofacial complex.
咽鼓管、腭帆张肌与颅底之间的矢量关系限制了中耳压力调节的效率,是咽鼓管功能计算模型所需的参数。在此,从颅骨重建这些关系,并在儿童和成人之间进行比较。
使用对先前描述技术的改进方法,对18例3 - 4岁儿童颅骨和20例成人颅骨(10名女性,10名男性;>18岁)进行重建。使用学生t检验比较组间测量和计算的变量。
与先前报告一致,成人颅骨的某些变量表现出性别二态性。儿童和成人之间,在颅底长度和宽度、硬腭宽度、鼻咽高度、宽度和深度、咽鼓管长度、腭帆张肌的最大和最小长度、腭帆张肌与咽鼓管的偏离角度以及腭帆张肌的表面积等测量值上存在显著差异。咽鼓管从颅底下降的角度、咽鼓管与矢状旁平面的偏离或腭帆张肌 - 咽鼓管角度的外侧分量在组间没有差异。
儿童和成人之间的差异可能解释了观察到的儿童咽鼓管功能较差的现象,包括其较短的咽鼓管、较小的腭帆张肌 - 咽鼓管矢量以及较小的腭帆张肌表面积。其他观察到的差异可归因于颅面复合体的生长和发育。