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[孤立性先天性中耳畸形:术前高分辨率CT与手术结果的比较]

[Isolated congenital middle ear malformations: comparison of preoperative HRCT and surgical findings].

作者信息

Zhang Na, Li Yi, Ma Xiaobo, Wang Danni, Zhao Shouqin

机构信息

Department of Otolaryngology,Head and Neck Surgery,Beijing Tongren Hospital,Capital Medical University;Key Laboratory of Otolaryngology,Head and Neck Surgery(Ministry of Education.

出版信息

Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2020 Sep;34(9):789-792;798. doi: 10.13201/j.issn.2096-7993.2020.09.006.

Abstract

To compare preoperative temporal bone HRCT readings to intraoperative findings during exploratory tympanotomy for suspected cases of isolated congenital middle ear malformations(CMEMs) and summarize the malformations that can be diagnosed with HRCT. A retrospective study was conducted. All cases were confirmed as isolated CMEMs during surgery. Detailed clinical records were reviewed, with a focus on imaging and surgical findings. One hundred and fifty-two patients and 168 ears were reviewed. One hundred and seven cases(63.7%) could be identified as isolated CMEMs and at least one as middle ear anomaly using preoperative HRCT. Sixty-one cases(36.3%) were reported to be completely normal and the patients underwent exploratory tympanotomy to determine the final diagnosis. Stapes fixation, either alone or associated with other ossicular chain anomalies, contributed to 51.2% of the cases.The stapes and incudostapedial complex are the most commonly involved structures. HRCT provides helpful preoperative clinical information in CMEM.Most cases of aplasia or dysplasia of the ossicular chain, e.g., aplasia/dysplasia of the long process of the incus, aplasia of the stapes'superstructure, and atresia of the oval window were easily identified in preoperative HRCT. However, fixation of the ossicular chain can be elusive in HRCT, and exploratory tympanotomy is needed for a definitive diagnosis.

摘要

比较疑似孤立性先天性中耳畸形(CMEMs)患者在中耳探查术中术前颞骨高分辨率计算机断层扫描(HRCT)结果与术中发现,并总结可通过HRCT诊断的畸形。进行了一项回顾性研究。所有病例在手术中均被确认为孤立性CMEMs。回顾详细的临床记录,重点关注影像学和手术结果。共回顾了152例患者和168只耳。107例(63.7%)术前HRCT可诊断为孤立性CMEMs且至少有一处中耳异常。61例(36.3%)术前报告完全正常,患者接受中耳探查术以明确最终诊断。镫骨固定单独或与其他听骨链异常并存,占病例的51.2%。镫骨和砧镫关节复合体是最常受累的结构。HRCT可为CMEM提供有用的术前临床信息。听骨链发育不全或发育异常的大多数病例,如砧骨长突发育不全/发育异常、镫骨上部结构发育不全和卵圆窗闭锁,术前HRCT易于识别。然而,听骨链固定在HRCT上可能难以发现,需要进行中耳探查术以明确诊断。

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本文引用的文献

1
Isolated Congenital Round Window Atresia: Report of 2 Cases.孤立性先天性圆窗闭锁:2 例报告。
Ear Nose Throat J. 2020 Aug;99(7):433-436. doi: 10.1177/0145561319840541. Epub 2019 Jun 2.
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Hearing Rehabilitation in Congenital Middle Ear Malformation.先天性中耳畸形的听力康复
Adv Otorhinolaryngol. 2018;81:32-42. doi: 10.1159/000485525. Epub 2018 Apr 6.
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Congenital anomalies of the incudostapedial joint.砧镫关节先天性异常。
Int J Pediatr Otorhinolaryngol. 2015 Dec;79(12):2277-80. doi: 10.1016/j.ijporl.2015.10.024. Epub 2015 Oct 25.
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Congenital incus fixation to the fallopian canal.
JAMA Otolaryngol Head Neck Surg. 2014 Aug;140(8):762-4. doi: 10.1001/jamaoto.2014.1026.
7
9
Classification of congenital middle ear anomalies. Report on 144 ears.先天性中耳畸形的分类。144例耳的报告。
Ann Otol Rhinol Laryngol. 1993 Aug;102(8 Pt 1):606-12. doi: 10.1177/000348949310200807.

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