岩浅大神经管及其周围结构的CT径线测量

目的探讨岩浅大神经管(greater superficial petrosal nerve canal,GSPNC)及其周围解剖结构在CT上的显示及其应用于颅中窝入路手术的重要意义。方法搜集我所行颞骨CT扫描的64例患者(内耳畸形、颞骨外伤史或颞骨手术史患者除外),在工作站上采用MPR后处理技术调整并显示GSPNC及其周围解剖结构的相对位置关系,测量主要结构间的径线值并进行统计学分析。结果测得GSPNC的平均长度为(2.9±2.5)mm(0～15.7)mm,膝状神经窝表面骨质平均厚度为(2.0±1.7)mm(0～7.4)mm,棘孔到岩浅大神经裂孔的平均距离为(10.3±2.2)mm(5.5～15.1)mm等;膝状神经节表面骨质厚度左右两侧存在统计学差异(P=0.033),余各结构间距离左右两侧无明显统计学差异。结论颞骨高分辨率CT图像上能够清楚显示颞骨内部各骨性解剖结构及其位置关系,对于欲行颅中窝入路颞骨岩部手术的患者行术前CT检查有利于实现手术方案的个性化选择。

CT evaluation of the greater superficial petrosal nerve canal and its surrounding structures

Objective To investigate the use of CT depiction of greater superficial petrosal nerve canal（GSPNC） and its surrounding structures in evaluation of middle fossa approach surgery.Methods This study included prospectively 64 consecutive patients without any structural abnormalities of inner ear,anamnesis of head trauma or surgical history of temporal bone undergoing CT scan for other reasons between August and November 2011 at our institute.Relative relationships of the main structures were depicted on CT images using MPR and obtained value in measurement of the main diameters were analyzed by SPSS 16.0.Results Mean length of GSPNC was（2.9±2.5） mm（0~15.7） mm.Mean thickness of bone covering geniculate ganglion was（2.0±1.7） mm（0~7.4） mm.Mean distance between spinous foramen and hiatus of great superficial petrosal nerve（GSPN） was（10.3±2.2） mm（5.5~15.1） mm.Significant difference existed in the bony thickness covering geniculate ganglion between left and right side.There was no significant difference in the other diameters between left and right side.Conclusion Temporal bone CT with high resolution has the ability to depict bony structures and their relative relationship of temporal bone.Conduction of pre-operational CT examination for the patients,who are going to undergo surgery utilizing middle cranial fossa approach,is helpful in selection of individualized surgical planning.