Hang Gai, Guan Jiangheng, Xie Hang, Feng Yu, Li Xiang, Zhang Meng, Sun Peng, Zhang Yanna, Han Zhitong, Zhang Ruijian, Xie Tianhao
People's Hospital of Inner Mongolia Autonomous Region, Hohhot, China.
Department of Neurosurgery, Central Theater General Hospital of Chinese PLA, No. 627 Wuluo Road, Wuhan, China.
Neurosurg Rev. 2025 Mar 19;48(1):309. doi: 10.1007/s10143-025-03457-6.
The anatomical importance of the vestibular aqueduct and posterior semicircular canal is explored in this study, which utilizes three-dimensional(3D) image reconstruction and registration fusion technology through the retrosigmoid approach for drilling the posterior wall of the internal auditory canal. A total of 200 temporal bone high-resolution computed tomography (HRCT) scans were collected from 100 patients without inner ear diseases at the Central Hospital of the PLA's Neurosurgery and Radiology Department between 2016 and 2024. Additionally, temporal bone HRCT and brain MRI imaging data were also collected concurrently from 32 patients diagnosed with vestibular schwannomas. The primary focus of this research is on 3D reconstruction and fusion registration of temporal bone HRCT and brain MRI images to accurately display and measure the anatomical structures as well as provide spatial positioning data in 3D dimensions for important structures such as the vestibular aqueduct, posterior semicircular canal, tumors, among others. Several important anatomical measurements were obtained using the 3D Reconstruction and fusion Technology. In non-tumor patients, the internal auditory canal measures (8.408 ± 1.078 mm), with P-1 (defined as the pole located near the posterior region on the long axis of an elliptical opening in the inner auditory canal) to vestibular aqueduct being (9.450 ± 1.522 mm) and to posterior semicircular canal being (10.348 ± 1.542 mm). In vestibular schwannoma patients, these dimensions change to (7.977 ± 0.903) mm, (7.598 ± 1.223 mm), and (8.687 ± 1.061 mm) respectively. Statistical analysis shows significant differences (p = 5.7416e-10 < 0.05, p = 5.8961e-9 < 0.05, p = 6.0e-6 < 0.05). ROC analysis sets a threshold of 8.438 mm from the internal auditory canal to the vestibular aqueduct, warning of caution near 8 mm during surgery to prevent vestibular aqueduct damage. In patients with vestibular schwannoma, the distance from the posterior internal auditory canal to the vestibular aqueduct is shorter compared to that of the posterior semicircular canal, implying a higher likelihood of damaging the vestibular aqueduct when eroding the posterior internal auditory canal during surgery.
本研究通过乙状窦后入路对内耳道后壁进行钻孔，利用三维（3D）图像重建和配准融合技术，探讨了前庭导水管和后半规管的解剖学意义。2016年至2024年期间，从解放军总医院神经外科和放射科的100例无内耳疾病患者中收集了200例颞骨高分辨率计算机断层扫描（HRCT）。此外，还同时收集了32例诊断为前庭神经鞘瘤患者的颞骨HRCT和脑部MRI成像数据。本研究的主要重点是颞骨HRCT和脑部MRI图像的3D重建和融合配准，以准确显示和测量解剖结构，并为前庭导水管、后半规管、肿瘤等重要结构提供三维空间定位数据。使用3D重建和融合技术获得了几个重要的解剖学测量值。在非肿瘤患者中，内耳道测量值为（8.408±1.078）mm，从内耳道椭圆开口长轴上靠近后部区域的极点（定义为P-1）到前庭导水管的距离为（9.450±1.522）mm，到后半规管的距离为（10.348±1.542）mm。在前庭神经鞘瘤患者中，这些尺寸分别变为（7.977±0.903）mm、（7.598±1.223）mm和（8.687±1.061）mm。统计分析显示存在显著差异（p = 5.7416e-10 < 0.05，p = 5.8961e-9 < 0.05，p = 6.0e-6 < 0.05）。ROC分析设定了从内耳道到前庭导水管的阈值为8.438 mm，警告手术中接近8 mm时要小心，以防止前庭导水管损伤。在前庭神经鞘瘤患者中，内耳道后部到前庭导水管的距离比到后半规管的距离短，这意味着手术中侵蚀内耳道后部时损伤前庭导水管的可能性更高。
