中耳炎鼓室窦CT分型与手术方式初探
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摘要
目的回顾性分析90例中耳炎患耳鼓室窦CT分型,旨在探讨耳内镜与显微镜手术处理后鼓室病变的适应证。方法所有患者术前行颞骨高分辨CT检查,记录鼓室窦CT分型(鼓室窦与面神经的关系),统计各型的例数和比例。结果 90例患耳的鼓室窦CT分型:A型43耳(47.78%),B型45耳(50%),C型2耳(2.22%)。结论鼓室窦CT分型以A型和B型居多,内镜中耳手术适合在中耳炎手术中推广,但C型鼓室窦的最佳手术方式仍是显微镜中耳手术。
Objective Retrospective analysis of tympanic sinus computed tomography(CT) classification(the relationship between the tympanic sinus and the facial nerve) in 90 ears with otitis media to explore the indications of endoscopic and microscopic surgery for the treatment of posterior tympanic disease.Methods Preoperative CT examinations of 90 ears with otitis media were retrospectively reviewed and classified.CT classifications were summarized,and the numbers and proportions of each type were analyzed.Results CT examinations of 90 ears with otitis media were classified as follows:type A,43 ears(47.78%);type B,45 ears(50%);and type C,two ears(2.22%).Conclusion Tympanic sinuses of types A and B are predominant;thus,endoscopic middle ear surgery is suitable for most cases of otitis media.However,microscopic surgery remains the best approach for tympanic sinuses of type C.
Objective Retrospective analysis of tympanic sinus computed tomography(CT) classification(the relationship between the tympanic sinus and the facial nerve) in 90 ears with otitis media to explore the indications of endoscopic and microscopic surgery for the treatment of posterior tympanic disease.Methods Preoperative CT examinations of 90 ears with otitis media were retrospectively reviewed and classified.CT classifications were summarized,and the numbers and proportions of each type were analyzed.Results CT examinations of 90 ears with otitis media were classified as follows:type A,43 ears(47.78%);type B,45 ears(50%);and type C,two ears(2.22%).Conclusion Tympanic sinuses of types A and B are predominant;thus,endoscopic middle ear surgery is suitable for most cases of otitis media.However,microscopic surgery remains the best approach for tympanic sinuses of type C.
引文
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[8]陈合新,虞春堂,钟世镇.颞骨内部结构CT三维重建的研究[J].中华耳鼻咽喉头颈外科杂志,2000,35(5):377.
[9]Marchioni D,Valerini S,Mattioli F,et al.Radiological assessment of the sinus tympani:temporal bone HRCT analyses and surgically related findings[J].Surg Radiol Anat,2014,37(4):385-392.
[2]Marchioni D,Mattioli F,Alicandri-Ciufelli M,et al.Transcanal endoscopic approach to the sinus tympani:a clinical report[J].Otol Neurotol,2009,30(6):758-765.
[3]Bonali M,Anschuetz L,Fermi M,et al.The variants of the retro-and hypotympanum:an endoscopic anatomical study[J].Eur Arch Otorhinolaryngol,2017,274(5):2141-2148.
[4]Tarabichi M,Kapadia M.Principles of endoscopic ear surgery[J].Curr Opin Otolaryngol Head Neck Surg,2016,24(5):382-387.
[5]Bennett ML,Zhang D,Labadie RF,et al.Comparison of middle ear visualization with endoscopy and microscopy[J].Otol Neurotol,2016,37(4):362-366.
[6]Marchioni D,Molteni G,Presutti L.Endoscopic anatomy of the middle ear[J].Indian J Otolaryngol Head Neck Surg,2011,63(2):101-113.
[7]Proctor B.Surgical anatomy of the posterior tympanum[J].Ann Otol Rhinol Laryngol,1969,78(5):1026-1040.
[8]陈合新,虞春堂,钟世镇.颞骨内部结构CT三维重建的研究[J].中华耳鼻咽喉头颈外科杂志,2000,35(5):377.
[9]Marchioni D,Valerini S,Mattioli F,et al.Radiological assessment of the sinus tympani:temporal bone HRCT analyses and surgically related findings[J].Surg Radiol Anat,2014,37(4):385-392.