小儿鼓室窦的放射解剖学：高分辨率 CT 研究。

On the radiologic anatomy of pediatric sinus tympani: HRCT study.

机构信息

Department of Descriptive and Clinical Anatomy, The Medical University of Warsaw, 5 Chalubinskiego St., 02004 Warsaw, Poland; Department of Otorhinolaryngology, Head and Neck Surgery, The Medical University of Warsaw, 1a Banacha St., 02097 Warsaw, Poland.

Department of Descriptive and Clinical Anatomy, The Medical University of Warsaw, 5 Chalubinskiego St., 02004 Warsaw, Poland; Department of Pediatric Neurosurgery, Bogdanowicz Memorial Hospital for Children, 4/24 Nieklanska St., 03924 Warsaw, Poland.

出版信息

Auris Nasus Larynx. 2022 Aug;49(4):606-612. doi: 10.1016/j.anl.2021.11.004. Epub 2021 Nov 26.

DOI:10.1016/j.anl.2021.11.004

PMID:34844809

Abstract

OBJECTIVE

Sinus tympani (ST) is considered the most constant among retrotympanic recesses but it is of great anatomical variability in shape and relation to mastoid portion of facial nerve. ST is difficult to access when clearing the cholesteatoma or serving as a window for cochlear implantation. The objective was to describe morphology of ST and assess feasibility of retrofacial approach in children under 5 years old.

METHODS

HRCT images of 150 children were reviewed. The type of sinus tympani was assessed according to Marchioni's classification. Width of entrance to sinus tympani (STW), depth of ST (STD), distance between the posterior semicircular canal and facial nerve (F-PSC), distance between the latter plane to the floor of ST at the right angle (P-ST) were measured. Width (HS-SS) and length (ML) of mastoid process were also measured.

RESULTS

From 300 temporal bones analyzed, the most common type of ST was type B (59.3%), followed by type C (34.3%) and type A (6.3%). The average depth of ST was 3.38±1.04 mm (1.32-8.24 mm) and mean value of F-PSC (width of retrofacial approach) was 4.91±0.75. The depth of ST (STD) presented significant deviations (ANOVA, p<0.05) among all three types. The value of ML increased with age (very high correlation).

CONCLUSION

Deep tympanic sinus (type C) is more frequent in children than in adult populations and it may suggest that pneumatization may affect the development of tympanic sinus final shape. Retrofacial approach can be used in selected pediatric patients after HRCT analysis.

摘要

目的

鼓窦（ST）被认为是后鼓室隐窝中最恒定的结构，但它在形状和面神经乳突段的关系上具有很大的解剖变异性。在清除胆脂瘤或作为耳蜗植入窗口时，ST 很难触及。目的是描述 ST 的形态，并评估在 5 岁以下儿童中采用后颅底入路的可行性。

方法

回顾了 150 例儿童的高分辨率 CT（HRCT）图像。根据 Marchioni 的分类评估鼓窦的类型。测量鼓窦入口宽度（STW）、ST 深度（STD）、后半规管和面神经之间的距离（F-PSC）以及后者平面与 ST 直角地板之间的距离（P-ST）。还测量了乳突的宽度（HS-SS）和长度（ML）。

结果

在分析的 300 个颞骨中，最常见的 ST 类型是 B 型（59.3%），其次是 C 型（34.3%）和 A 型（6.3%）。ST 的平均深度为 3.38±1.04mm（1.32-8.24mm），F-PSC（后颅底入路的宽度）的平均值为 4.91±0.75。所有三种类型的 ST 深度（STD）均存在显著差异（ANOVA，p<0.05）。ML 值随年龄增加而增加（高度相关）。