[小耳畸形患者耳廓及中耳畸形的断层解剖分析]

[Sectional anatomical analysis of auricular and middle ear malformation in patients with microtia].

作者信息

Han Juan, Lu Jiu-xing, Xing Ning, Lin Lin, Jiang Hai-yue, Zhuang Hong-xing

机构信息

Plastic Surgery Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100144, China.

出版信息

Zhonghua Zheng Xing Wai Ke Za Zhi. 2011 May;27(3):217-21.

PMID:21838005

Abstract

OBJECTIVE

To analyze the sectional anatomical features of auricular and middle ear malformation in patients with microtia so as to improve the clinical classification and the instruction of surgery.

METHODS

From Jun. to Dec. 2009, 36 cases with microtia were selected in the center of auricular reconstruction in Plastic Surgery Hospital, including 22 cases of unilateral microtia and 14 cases of bilateral microtia. 22 patients with unilateral microtia were studied with the contralateral healthy ears as controls. Spiral CT was performed for high-resolution scan of the temporal bone. The coronal, sagittal and 3D reconstruction images were created with Mimic software. Several distances and degrees were measured.

RESULTS

The patients were classified by Max classification. The anteroposterior diameter and the vertical diameter of tympanic cavity were (7.75 +/- 1.92) mm and (14.66 +/- 4.75) mm for type I; (6.17 +/- 2.56) mm and(14.35 +/- 5.12) mm for type II; (6.31 +/- 3.40) mm and (9.97 +/- 4.36) mm for type III (P = 0.001). The mastoid pneumatization degree for type I, II, III were 13.33%, 13.64%, 30.77% in sclerotic type, 13.33%, 18.18%, 7.69% in diploe type, 0, 9.09%, 38.46% in composite type, 73.33%, 59.09%, 23.08% in pneumatic type (chi2 = 24.11, P = 0.002). The cover of fenestra vestibuli by facial nerve was 21.43%, 47.62%, 54.55% (chi2 = 23.44, P = 0.002) for type I, II, III. There was a statistical difference between the microtia group and the control group.

CONCLUSIONS

According to the Max classification, the middle ear malformation changed along the auricular malformation. The anatomical variations was complicated in type II microtia, which should be sub-classified.

摘要

目的

分析小耳畸形患者耳廓及中耳畸形的断层解剖特征，以完善临床分型并指导手术。

方法

2009年6月至12月，选取中国医学科学院整形外科医院耳廓再造中心收治的36例小耳畸形患者，其中单侧小耳畸形22例，双侧小耳畸形14例。以22例单侧小耳畸形患者的健侧耳为对照。对颞骨行螺旋CT高分辨率扫描，利用Mimic软件进行冠状位、矢状位及三维重建，测量相关距离及角度。

结果

按Max分类法对患者进行分型。I型鼓室前后径及上下径分别为(7.75±1.92)mm和(14.66±4.75)mm；II型分别为(6.17±2.56)mm和(14.35±5.12)mm；III型分别为(6.31±3.40)mm和(9.97±4.36)mm(P = 0.001)。I型、II型、III型中耳乳突气化程度在硬化型分别为13.33%、13.64%、30.77%，板障型分别为13.33%、18.18%、7.69%，混合型分别为0、9.09%、38.46%，气化型分别为73.33%、59.09%、23.08%(χ2 = 24.11，P = 0.002)。I型、II型、III型面神经遮盖前庭窗的比例分别为21.43%、47.62%、54.55%(χ2 = 23.44，P = 0.002)。小耳畸形组与对照组比较差异有统计学意义。