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科恩氏隔(岩鳞骨板):解剖变异还是临床问题?

Körner's septum (petrosquamosal lamina): the anatomical variant or clinical problem?

机构信息

Department of Otolaryngology, Medical University of Gdansk, Smoluchowskiego 17 Str., 80-214 Gdańsk, Poland.

Department of Clinical Anatomy, Medical University of Gdansk, Dębinki 1 Str., 80-211 Gdańsk, Poland.

出版信息

Folia Morphol (Warsz). 2020;79(2):205-210. doi: 10.5603/FM.a2019.0079. Epub 2019 Aug 26.

Abstract

Körner's septum (KS) or petrosquamosal lamina is a bony lamina beginning at the articular fossa, extending above the middle ear, and running inferiorly and laterally to the facial nerve canal as it proceeds to the mastoid apex. This septum marks the junction of petrous and squamous bones. The paper presents details of the anatomical structure of KS, which is most often present at the level of the head of the malleus and/or the anterior semicircular canal. Attention is paid to embryological aspects of temporal bone development that lead to the formation of KS. Two imaging techniques most frequently used to diagnose KS are described, high resolution computed tomography (HRCT) and cone-beam computed tomography. Also presented is a case report of a 6-year-old patient suffering from chronic otitis media who developed a cholesteatoma due to presence of KS, illustrated with HRCT images and intraoperative capture. The authors describe diagnostic difficulties associated with this anatomical variant in the middle ear. The article also discusses the more frequent occurrence of this clinical problem in ears operated on due to chronic inflammation, retraction pocket or tympanosclerosis in comparison to healthy ears.

摘要

科恩氏隔(KS)或岩鳞骨板是一种起始于关节窝、延伸至中耳上方、向下和向外侧延伸至面神经管的骨板,然后向乳突尖部行进。该隔标志着岩骨和鳞骨的交界处。本文详细介绍了 KS 的解剖结构,KS 通常位于锤骨头和/或前半规管水平。关注导致 KS 形成的颞骨发育的胚胎学方面。描述了两种最常用于诊断 KS 的成像技术,高分辨率计算机断层扫描(HRCT)和锥形束计算机断层扫描。还报告了一例 6 岁慢性中耳炎患者的病例,由于 KS 的存在导致胆脂瘤的形成,用 HRCT 图像和术中捕获进行了说明。作者描述了与中耳这种解剖变异相关的诊断困难。文章还讨论了与慢性炎症、回缩袋或鼓室硬化症相关的耳朵相比,健康耳朵中这种临床问题更为常见。

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