Deshpande Anita Satish, Soares Bruno Passebon, Todd Norman Wendell
Department of Otolaryngology, Head and Neck Surgery, Emory University School of Medicine, 2015 Uppergate Drive, Atlanta, GA, 30322, USA.
Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, GA, USA.
Surg Radiol Anat. 2018 Jun;40(6):697-704. doi: 10.1007/s00276-018-2017-1. Epub 2018 Apr 26.
Quantitative description in adult crania of (1) angular orientation of the basal turn of the cochlea relative to the sagittal (termed "rotation") and Frankfort horizontal (termed "tilt") planes, and angle theta 3 [angular relationship of the line defined by the cochlea's spiral center and cochlear (round) window, to the cochlear window]; (2) orientation of the cochlea relative to the plane defined by the horizontal and vertical portions of the facial nerve; (3) orientation of the basal turn of the cochlea relative to the plane of the posterior semicircular canal; and (4) the association of these orientations with the extent of mastoid pneumatization.
Postmortem material analysis. From 41 bequeathed anatomical ear-normal cadaveric cranial, high-resolution CT scans were performed of the five crania with the largest and the five with the smallest mastoids. Eleven points in three-dimensional Cartesian space were appointed and studied with the software program FIJI.
The median angle values (and ranges) for right ears were: "rotation" 52° (range 47-61); and, "tilt" 84° (79-89). The planes of the cochlear basal turn and facial nerve approximated superimposition: median 15° (2-19). Angle theta 3 for right ears was median 40° (28-44). Bilateral symmetry was found for the relationships between the planes. However, no association of any planar relationship with mastoid pneumatization was suggested.
Considering the range of angles found in clinically normal adult specimens, spatial orientation of the cochlea may explain some of the difficulties in implantation.
对成人颅骨进行定量描述,包括:(1) 耳蜗底转相对于矢状面(称为“旋转”)和法兰克福水平面(称为“倾斜”)的角度方向,以及θ3角[由耳蜗螺旋中心和耳蜗(圆)窗所确定的线与耳蜗窗的角度关系];(2) 耳蜗相对于由面神经水平和垂直部分所确定平面的方向;(3) 耳蜗底转相对于后半规管平面的方向;(4) 这些方向与乳突气化程度的关联。
尸体材料分析。对41例遗留的解剖学上耳部正常的尸体颅骨,对乳突最大的5例颅骨和乳突最小的5例颅骨进行高分辨率CT扫描。在三维笛卡尔空间中指定11个点,并用软件程序FIJI进行研究。
右耳的中位数角度值(及范围)为:“旋转”52°(范围47 - 61);“倾斜”84°(79 - 89)。耳蜗底转平面与面神经平面近似重叠:中位数为15°(2 - 19)。右耳的θ3角中位数为40°(28 - 44)。各平面之间的关系存在双侧对称性。然而,未发现任何平面关系与乳突气化有关联。
考虑到临床正常成人标本中发现的角度范围,耳蜗的空间方向可能解释了植入过程中的一些困难。