Ocak Mert, Geneci Ferhat, Torun Bilge İpek, Şentürk Mehmet Fatih, Çakmak Emine Şebnem Kurşun
Faculty of Dentistry, Department of Anatomy, Ankara University, Yenimahalle, Ankara, 06560, Turkey.
Faculty of Medicine, Department of Anatomy, Ankara Yıldırım Beyazıt University, Ankara, Turkey.
Head Face Med. 2025 Apr 28;21(1):33. doi: 10.1186/s13005-025-00485-x.
Selecting the correct imaging technique for critical anatomical structures is essential in descriptive studies and for supporting clinical applications. Facial canal dehiscence poses a significant risk for iatrogenic facial nerve injuries during middle ear surgeries. Accurate imaging is critical for surgical planning and minimizing complications. Detection of facial canal openings in the clinic is performed using imaging methods such as high-resolution computed tomography (HRCT). Studies have shown that the sensitivity of this method is approximately 66%. A high-resolution, 3D imaging method was used to measure the sensitivity of HRCT in the most accurate way.
AIMS/OBJECTIVES: This study aimed to compare two radiological methods for measuring facial canal dehiscence. Specifically, we compared cone-beam computed tomography (CBCT) with high-resolution micro-computed tomography (micro-CT).
Thirty-six temporal bone specimens without external defects were used. The specimens were scanned using both CBCT and micro-CT. The presence of facial canal dehiscence in the tympanic segment of the facial nerve (FN) was evaluated. A paired sample t-test was used for statistical analysis, with significance set at p < 0.05.
Facial canal dehiscence was detected in 10 bones on micro-CT images, while 26 bones appeared intact. In contrast, CBCT images showed dehiscence in 25 bones, with 11 bones intact. Additionally, the mean dehiscence width was 3.469 mm (range: 1.577-8.921 mm) in micro-CT images, compared to 1.279 mm (range: 0.670-9.354 mm) in CBCT images. In the 10 bones where dehiscence was identified by both methods, the average width of the dehiscence measured 5.347 mm (range: 1.840-9.354 mm) in the CBCT images. The difference in measurements between CBCT and micro-CT was statistically significant (p < 0.05).
The low resolution of CBCT was insufficient for visualizing the thin bony tissue lining the facial canal. These findings suggest that the frequency of facial canal dehiscence measured in preoperative CBCT images may be overestimated compared to actual anatomical conditions. These findings provide critical insights for preoperative evaluation and surgical planning in middle ear procedures.
在描述性研究和支持临床应用中，为关键解剖结构选择正确的成像技术至关重要。面神经管裂开在中耳手术期间会带来医源性面神经损伤的重大风险。准确的成像对于手术规划和将并发症降至最低至关重要。临床上使用高分辨率计算机断层扫描（HRCT）等成像方法检测面神经管开口。研究表明，这种方法的灵敏度约为66%。一种高分辨率的三维成像方法被用于以最准确的方式测量HRCT的灵敏度。
本研究旨在比较两种测量面神经管裂开的放射学方法。具体而言，我们将锥形束计算机断层扫描（CBCT）与高分辨率微计算机断层扫描（微CT）进行了比较。
使用36个无外部缺陷的颞骨标本。这些标本分别用CBCT和微CT进行扫描。对面神经管鼓室段面神经（FN）裂开的情况进行评估。采用配对样本t检验进行统计分析，显著性设定为p < 0.05。
在微CT图像上，10块骨头检测到面神经管裂开，26块骨头显示完整。相比之下，CBCT图像显示25块骨头有裂开，11块骨头完整。此外，微CT图像中裂开的平均宽度为3.469毫米（范围：1.577 - 8.921毫米），而CBCT图像中为1.279毫米（范围：0.670 - 9.354毫米）。在两种方法都识别出裂开的10块骨头中，CBCT图像中裂开的平均宽度为5.347毫米（范围：1.840 - 9.354毫米）。CBCT和微CT测量结果的差异具有统计学意义（p < 0.05）。
CBCT的低分辨率不足以显示面神经管内衬的薄骨组织。这些发现表明，与实际解剖情况相比，术前CBCT图像中测量的面神经管裂开频率可能被高估。这些发现为中耳手术的术前评估和手术规划提供了关键见解。
