Karpishchenko S A, Zubareva A A, Filimonov V N, Shavgulidze M A, Azovtseva E A
I.P. Pavlov Saint-Petersburg First State Medical University, Russian Ministry of Health, Saint-Petersburg, Russia, 197022.
Vestn Otorinolaringol. 2016;81(4):10-13. doi: 10.17116/otorino201681410-13.
The objective of the present study was to analyze the potential of cone beam computed tomography of the temporal bones in the patients presenting with otosclerosis for the detection of surgically significant specific structural features of the labyrinth wall of the tympanic cavity. More than 400 tomograms of the temporal bones were obtained with the use of a cone beam tomographwere available for the investigation during the period from 2012 till 2016. The study was carried out in several steps, viz. the search for the optimal (for the given instrument) position of the patient, the experimental stage, the retrospective analysis of the tomograms and the comparison of the temporal bones of different types (pneumatic, mixed, and sclerotic) in individual patients, the comparison of the results of cone beam computed tomography (CBCT) with the intraoperative observations, and the modification of the algorithm for the analysis of temporal bone cone beam tomograms. The study included a total of 16 patients (15 women at the age from 32 to 56 years and one managed 58 years) presenting with the clinical diagnosis of otosclerosis. The results of the study were used to elaborate the algorithm for the analysis of cone beam tomograms of the temporal bones to be performed inthe stage by stage manner including the qualitative analysis of tomograms, evaluation of their quantitative parameters and additional characteristics to be taken into consideration when planning the surgical interventions on the labyrinth wall and the tympanic cavity as a preparation for the stapedoplastic treatment. The results of CBCT obtained in the present study were compared with the surgical observations. The diagnostic sensitivity and specificity of the method were estimated to be 100% and 83% respectively. It is concluded that cone beam computed tomography can be employed as a component of the diagnostic algorithm prior to the planning of surgical interventions onthe medial wall of the tympanic cavity and the assessment of dynamics of the clinical course of middle ear diseases.
本研究的目的是分析颞骨锥形束计算机断层扫描在耳硬化症患者中检测鼓室迷路壁具有手术意义的特定结构特征的潜力。在2012年至2016年期间,使用锥形束断层扫描仪获得了400多张颞骨断层图像用于研究。该研究分几个步骤进行,即寻找患者的最佳(针对给定仪器)位置、实验阶段、对断层图像的回顾性分析以及对个体患者不同类型(气化型、混合型和硬化型)颞骨的比较、将锥形束计算机断层扫描(CBCT)结果与术中观察结果进行比较,以及修改颞骨锥形束断层图像分析算法。该研究共纳入16例临床诊断为耳硬化症的患者(15名年龄在32至56岁的女性和1名58岁男性)。研究结果用于制定颞骨锥形束断层图像分析算法,该算法将分阶段进行,包括断层图像的定性分析、评估其定量参数以及在规划鼓室迷路壁和鼓室手术干预时要考虑的其他特征,作为镫骨成形术治疗的准备。将本研究中获得的CBCT结果与手术观察结果进行比较。该方法的诊断敏感性和特异性分别估计为100%和83%。得出的结论是,在规划鼓室内侧壁手术干预和评估中耳疾病临床病程动态之前,锥形束计算机断层扫描可作为诊断算法的一个组成部分。