Sun S P, Lu W, Lei Y B, Men X M, Zuo B, Ding S G
Division of Otology, Otorhinolaryngology Hospital, the First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China.
Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2017 Aug 7;52(8):561-565. doi: 10.3760/cma.j.issn.1673-0860.2017.08.001.
To discuss the prediction of round window(RW) visibility in cochlear implantation(CI) with temporal bone high resolution computed tomography(HRCT). From January 2013 to January 2017, 130 cases underwent both HRCT and CI in our hospital were analyzed. The distance from facial nerve to posterior canal wall(FWD), the angle between facial nerve and inner margin of round window(FRA), and the angle between facial nerve and tympanic anulus to inner margin of round window(FRAA) were detected at the level of round window on axial temporal bone HRCT. A line parallel to the posterior wall of ear canal was drawn from the anterior wall of facial nerve at the level of round window on axial temporal bone HRCT and its relationship with round window was detected (facial-round window line, FRL): type0-posterior to the round window, type1-between the round window, type2-anterior to the round window. Their(FWD, FRA, FRAA, FRL) relationships with intra-operative round window visibility were analyzed by SPSS 17.0 software. FWD(=18.76, =0.00), FRA(=34.57, =0.00), FRAA (=14.24, =0.00) could affect the intra-operative RW visibility significantly. RW could be exposed completely during CI when preoperative HRCT showing type0 FRL. RW might be partly exposed and not exposed when preoperative HRCT showing type1 and type2 FRL respectively. FWD, FRA, FRAA and FRL of temporal bone HRCT can predict intra-operative round window visibility effectively in CI surgery.
探讨颞骨高分辨率计算机断层扫描(HRCT)对人工耳蜗植入(CI)术中圆窗(RW)可视化的预测作用。回顾性分析2013年1月至2017年1月在我院行HRCT及CI的130例患者资料。在颞骨轴向HRCT圆窗层面测量面神经至后半规管后壁距离(FWD)、面神经与圆窗内缘夹角(FRA)、面神经与鼓环至圆窗内缘夹角(FRAA)。在颞骨轴向HRCT圆窗层面自面神经前壁画一条与外耳道后壁平行的线,观察其与圆窗的关系(面神经-圆窗线,FRL):0型-位于圆窗后方;1型-位于圆窗之间;2型-位于圆窗前方。采用SPSS 17.0软件分析FWD、FRA、FRAA、FRL与术中圆窗可视化的关系。FWD(P=0.00)、FRA(P=0.00)、FRAA(P=0.00)对术中RW可视化有显著影响。术前HRCT显示FRL为0型时,CI术中RW可完全暴露;术前HRCT显示FRL为1型和2型时,RW可能部分暴露或未暴露。颞骨HRCT的FWD、FRA、FRAA及FRL可有效预测CI手术中术中圆窗的可视化情况。