Department of Otorhinolaryngology, Head and Neck Surgery, Eye and ENT Hospital, Fudan University, 83 Fenyang Road, Shanghai, 200031, China,
Eur Arch Otorhinolaryngol. 2014 May;271(5):987-91. doi: 10.1007/s00405-013-2503-3. Epub 2013 Apr 26.
The aim of the present study is to determine whether coronary CT images of the temporal bone are useful to predict a bulging second genu of the facial nerve (SGFN) in mastoidectomy by measuring and comparing the heights of the SGFN above the prominence of the lateral semicircular canal (PLSC) in medial-to-lateral dimension on coronary CT images and in mastoidectomy. The relationship between the SGFN and the PLSC in medial-to-lateral dimension, which may have big variability, can be evaluated on the coronary CT images of the temporal bone. The heights of the SGFN above the PLSC in medial-to-lateral dimension were measured on coronary CT images and in mastoidectomy in 184 patients. If the SGFN is above the PLSC in medial-to-lateral dimension, we called the SGFN a bulging SGFN. The data measured on CT images and in surgery were described in histograms and compared. The sensitivity and the specificity in the diagnosis of a bulging SGFN on CT images were calculated by comparison with surgical measurement. Cohen's kappa coefficient was calculated. The heights of the SGFN above the PLSC measured in medial-to-lateral dimension varied from -2.9 to 2.9 mm on coronary CT images and varied from -3.0 to 3.0 mm in surgery. The data measured in surgery showed that the SGFN was above the PLSC in medial-to-lateral dimension in 27.7% (51/184) patients, at least 1 mm above the PLSC in 15.8% (29/184) patients and at least 2 mm above the PLSC in 6.0% (13/184) patients. The sensitivity and the specificity for CT diagnosis of a bulging SGFN were 100% (51/51) and 91.0% (121/133), respectively. Bulging SGFN can be predicted by measuring the height of the SGFN above the PLSC on coronary CT images of the temporal bone.
本研究旨在通过测量和比较冠状位颞骨 CT 图像中面神经第二膝状突（SGFN）高于外半规管隆凸（PLSC）的高度，来确定颞骨冠状位 CT 图像是否有助于预测乳突切除术中面神经第二膝状突膨出（SGFN）。SGFN 与 PLSC 在内外径上的关系具有很大的可变性，可以在颞骨冠状位 CT 图像上进行评估。在 184 例患者中，我们分别在冠状位 CT 图像和乳突切除术中测量了 SGFN 高于 PLSC 的高度。如果 SGFN 在内外径上高于 PLSC，我们称其为膨出的 SGFN。对 CT 图像和手术中测量的数据进行了直方图描述和比较。通过与手术测量值进行比较，计算 CT 图像诊断膨出 SGFN 的灵敏度和特异性。计算 Cohen's kappa 系数。冠状位 CT 图像上测量的 SGFN 高于 PLSC 的高度在内外径上从-2.9 到 2.9mm 不等，手术中从-3.0 到 3.0mm 不等。手术中测量的数据显示，在 27.7%（51/184）的患者中，SGFN 在内外径上高于 PLSC，至少 1mm 高于 PLSC 的患者占 15.8%（29/184），至少 2mm 高于 PLSC 的患者占 6.0%（13/184）。CT 诊断膨出 SGFN 的灵敏度和特异性分别为 100%（51/51）和 91.0%（121/133）。通过测量冠状位颞骨 CT 图像中 SGFN 高于 PLSC 的高度，可以预测 SGFN 是否膨出。
