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咽鼓管骨段和软骨段的年龄相关形态学变化

Age-related morphological change in bony segment and cartilage segment of Eustachian tube.

作者信息

Hong Juan, Dai Peidong, Sun Guangbin, Lin Lin, Lyu Huiying, Chen Keguang

机构信息

Department of Otorhinolaryngology Huashan Hospital of Fudan University Shanghai China.

ENT Institute Eye & ENT Hospital of Fudan University Shanghai China.

出版信息

Laryngoscope Investig Otolaryngol. 2024 May 13;9(3):e1262. doi: 10.1002/lio2.1262. eCollection 2024 Jun.

DOI:10.1002/lio2.1262
PMID:38741682
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11089444/
Abstract

BACKGROUND

Eustachian tube dysfunction (ETD) is the predominant cause of otitis media with effusion in children and adults. Balloon dilatation of the Eustachian tube (BDET) provides a new method for restoring the ventilatory function of Eustachian tube (ET). However, the differences in age-related morphological changes in the dimensions and positions of ET in children and adults are unclear.

PURPOSE

This study aimed to examine age-related morphological changes in bony and cartilage segments of the ET in a three-dimensional space in normal population.

METHODS

A total of 71 randomly selected computed tomography (CT) images of the temporal bones of 46 people were retrospectively studied in four age groups: A (0-3 years old); B (4-8 years old), C (9-18 years old), and D (19-65 years old). Space analytic geometry was assessed to calculate the dimensions and positions of ET.

RESULTS

The bony segment of ET lengthened from infancy to adulthood with age in groups A, B and C ( = 0.562**/0.000). The cartilage segment of ET mostly extended with age from infancy to 8 years old in children ( = 0.633**/0.000), but with bending close to the sagittal plane and away from the horizontal plane with age in groups A, B and C ( < .05), and with a constant angle to the coronal plane among the four groups ( > .05).

CONCLUSION

The bony and cartilaginous segments of ET exhibit distinct morphological changes in space with age. The bony segment of ET extends in a constant position from infancy to adulthood. In contrast, the cartilaginous segment of the ET indicates multidimensional positional changes until adulthood, in addition to the elongation from infancy to children. This may provide an accurate morphological basis for comparing the differences in ETD pathogenesis and surgical treatment between children and adults.

摘要

背景

咽鼓管功能障碍(ETD)是儿童和成人中耳积液的主要原因。咽鼓管球囊扩张术(BDET)为恢复咽鼓管(ET)的通气功能提供了一种新方法。然而,儿童和成人ET在尺寸和位置上与年龄相关的形态学变化差异尚不清楚。

目的

本研究旨在探讨正常人群中ET的骨性和软骨段在三维空间中与年龄相关的形态学变化。

方法

回顾性研究了随机选取的46人的71张颞骨计算机断层扫描(CT)图像,分为四个年龄组:A组(0 - 3岁);B组(4 - 8岁),C组(9 - 18岁),D组(19 - 65岁)。采用空间解析几何方法评估ET的尺寸和位置。

结果

A、B、C组中,ET的骨性段从婴儿期到成年期随年龄增长而延长(= 0.562**/0.000)。儿童ET的软骨段大多从婴儿期到8岁随年龄增长而延长(= 0.633**/0.000),但A、B、C组中随年龄增长其弯曲靠近矢状面并远离水平面(< 0.05),且四组中与冠状面的夹角恒定(> 0.05)。

结论

ET的骨性和软骨段随年龄增长在空间上呈现出明显的形态学变化。ET的骨性段从婴儿期到成年期在固定位置延伸。相比之下,ET的软骨段除了从婴儿期到儿童期的延长外,在成年前还表现出多维度位置变化。这可能为比较儿童和成人ETD发病机制及手术治疗差异提供准确的形态学依据。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fd06/11089444/65c3e8665641/LIO2-9-e1262-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fd06/11089444/bf96e0699ec3/LIO2-9-e1262-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fd06/11089444/ba05a7a12a34/LIO2-9-e1262-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fd06/11089444/82320cbfffd5/LIO2-9-e1262-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fd06/11089444/65c3e8665641/LIO2-9-e1262-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fd06/11089444/bf96e0699ec3/LIO2-9-e1262-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fd06/11089444/ba05a7a12a34/LIO2-9-e1262-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fd06/11089444/82320cbfffd5/LIO2-9-e1262-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fd06/11089444/65c3e8665641/LIO2-9-e1262-g004.jpg

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本文引用的文献

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Patulous Eustachian Tube Dysfunction Symptoms Following Balloon Dilation.球囊扩张后咽鼓管异常开放症的症状。
Laryngoscope. 2023 Nov;133(11):3152-3157. doi: 10.1002/lary.30659. Epub 2023 Mar 17.
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Measurements of The Pediatric Cartilaginous Eustachian Tube: Implications for Balloon Dilation.小儿鼓室管软骨的测量:对球囊扩张的影响。
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Developmental Anatomy of the Eustachian Tube: Implications for Balloon Dilation.咽鼓管的发育解剖:对球囊扩张的影响。
Otolaryngol Head Neck Surg. 2021 Dec;165(6):862-867. doi: 10.1177/0194599821994817. Epub 2021 Feb 23.
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Otolaryngol Head Neck Surg. 2020 Nov;163(5):870-882. doi: 10.1177/0194599820924322. Epub 2020 Jun 2.
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