经岩乙状窦前入路的相关影像学研究

目的:为该入路提供影像解剖依据,减少术后并发症。方法:对10例成人头颅标本先行高分辨率CT岩骨薄层扫描,后用磨钻对标本轮廓化骨迷路,分别测量与该入路有关的后半规管及乙状窦沟与周围骨质的距离。结果:CT扫描测量乙状窦沟宽是11.44±1.79mm,深是5.27±1.93mm,乙状窦沟底到乳突外表面的距离是10.38±3.90mm,乙状窦沟前壁到外耳道后壁的距离是13.66±2.18mm。后半规管最外侧至乳突外表面的最近距离是13.44±1.86mm,至乙状窦沟前缘的距离是9.65±1.76mm,其最后部至岩骨后壁的距离是2.92±0.98mm。对应的解剖测量结果分别是11.26±1.58mm、5.12±1.88mm、10.26±3.78mm、13.74±1.96mm、13.86±1.98mm、9.82±1.91mm和3.12±1.08mm。CT扫描测量与解剖测量结果统计学上无显著性差异(P>0.05)。结论:CT扫描测量结果可代表实际的相关解剖结构的距离,CT岩骨薄层扫描可指导经岩乙状窦前入路中岩骨后外侧壁的安全磨除。

IMAGEOLOGY STUDY IN PRESIGMOID APPROACH

Objective To supply relevant image anatomy basis for transpetrous presigmoid approach and reduce the emergence of operation complications. Methods Ten cadaveric adult heads were performed CT thin tomographic scan of petrous bone first ,and then outlined bony labyrinth of them, and measure the relevant distance from the posterior semicircular canal and groove of sigmoid sinus to adjacent bony structures. Results Width of GSS, Depth of GSS, the distance from the lateral wall of GSS to the surface of mastoid process, the distance from the anterior wall of GSS to the posterior wall of external auditory meatus, the distance from the most lateral portion of PSC to the surface of mastoid process, the distance from the most lateral portion of PSC to the anterior edge of GSS, the distance t~om the most posterior portion of PSC to the posterior pyramidal wall were 11.44±1.79mm, 5.27±1.93mm, 10.3 8±3.90mm, 13.66±2.18mm, 13.44± 1.8mm,9.65± 1.76mm,2.92±0.98m m respectively lneasured by CT scan. The results of anatomic measurement were 11.26±l.58mln, 5.12±1.88mm, 10.26±3.78mm, 13.74±1.96mm, 13.86±1.98mm, 9.82=t:1.91mm, 3.12±l.08mm. There were not statistically significant between measured by CT scan and anatomic lneasurement(P >0.05 ). Conclusion CT thin tomographic scan could guide drilling the lateral and posterior wall of petrous bone safely and effectively, and prevent damaging its important functional structures inside.