Department of Otology and Skull Base Surgery, Eye Ear Nose and Throat Hospital of Fudan University, Shanghai, People's Republic of China.
Otol Neurotol. 2011 Dec;32(9):1579-82. doi: 10.1097/MAO.0b013e3182355671.
To clarify the position, occurrence rate, and configuration of the suprapyramidal fossa (SF) through surgical observation and 3-dimensional reconstruction.
SF of 300 ears with chronic otitis media were observed during surgery. The air cell and its abutting structures, including the facial nerve (FN), were reconstructed using high-resolution computed tomography (HRCT) data.
In 68.3% (n = 205) of patients, the SF was observed in surgery. It is situated at the posterior wall of the facial recess of the retrotympanum. This air cell, usually the only one present on the surface of the pyramidal segment of the FN canal (FNC), is usually the largest if small air cells are found nearby. Its delineated location is as follows: pyramidal eminence and the pyramidal segment of the FNC medially, the deeper external acoustic meatus laterally, the aditus ad antrum superiorly, the posterior part of the tympanic annulus, and the chordal ridge anterior-inferiorly. Its configuration varies between rounded (11.7%, n = 35), curved-rod (52.7%, n = 158), and irregular (4%, n = 12). Additionally, the sensitivity and specificity of HRCT in detecting the SF were 79.0% and 88.4%, respectively.
Occurrence and configuration of the SF is not a rule; however, the positive positional relationship between the SF and the second genu of the FNC is a rule, if the SF is detected. Considering this, the SF may be an important anatomic landmark to identify the FN during otosurgery. However, HRCT has a limited diagnostic value when the SF is atypical.
通过手术观察和三维重建，阐明上锥体腔（SF）的位置、发生率和形态。
在手术中观察了 300 例慢性中耳炎患者的 SF。使用高分辨率计算机断层扫描（HRCT）数据重建气房及其毗邻结构，包括面神经（FN）。
在 68.3%（n=205）的患者中，在手术中观察到了 SF。它位于后鼓室面神经隐窝的后壁。这个气房通常是 FN 管锥体段表面上唯一存在的气房（如果附近有小的气房，则通常是最大的）。它的位置界定如下：内侧为锥体隆起和 FN 的锥体段，外侧为较深的外耳道，上方为鼓窦入口，后鼓膜环的后部和前下的弦状嵴。其形态在圆形（11.7%，n=35）、弯曲杆状（52.7%，n=158）和不规则（4%，n=12）之间变化。此外，HRCT 检测 SF 的敏感性和特异性分别为 79.0%和 88.4%。
SF 的发生和形态并非规则，但如果检测到 SF，则 SF 与 FN 的第二膝之间的阳性位置关系是规则的。考虑到这一点，SF 可能是耳科手术中识别 FN 的重要解剖标志。然而，当 SF 不典型时，HRCT 的诊断价值有限。
