HRCT多平面重组耳蜗形态测量在人工耳蜗植入术的应用

目的：运用颞骨高分辨率CT（HRCT）多平面重组（MPR）技术测量人工耳蜗植入患者的耳蜗形态，探讨其在人工耳蜗植入术前评估中的应用价值。方法：收集符合入组标准的80例人工耳蜗植入患者资料，根据患者的性别、年龄及有无内耳畸形进行分组；对患者术前颞骨CT进行MPR，在标准方位图像下分别测量耳蜗长径A、宽径B及底转角度7，对测量的数据进行可重复性评价及对不同组间的结果进行比较。结果：各组测量参数值在测量者自身和测量者之间的一致性较好；内耳正常组男性耳蜗长径A（8．79士0．34）mm]及宽径B（6．58士0．28）mm]均大于女性耳蜗长径A（8．534士0．47）mm]和宽径B（6．22±0．43）mm]，差异均有统计学意义（P〈O．05），但底转角度7无性别差异（P〉0．05）；耳蜗长径A及宽径B不随年龄的增长而变化（P〉O．05），但底转角度7随着年龄的增长呈逐渐减小趋势（r=-0．25，P〈0．05）；内耳畸形组患者耳蜗宽径B较耳蜗正常组小（P〈0．01），但两组的耳蜗长径A及底转角度7差异无统计学意义（P〉O．05）。结论：术前应用HRCTMPR技术测量耳蜗形态方法简单可行、重复性好，可用于指导手术及为设计个性化电极提供客观依据，值得临床推广。

Application of HRCT multi-planar reconstruction for measuring cochlear morphology in cochlear implantation

To exptore me value of high-resolution temporal boneCT（HRCT） multi-planar recon-struction （MPR） technique for measuring cochlear morpholog in the preoperative evaluation of cochlear implant. Method：We retrospectively analyzed the clinical data of 80 cochlear implant recipients. The groups were investiga- ted in our reserch according to the patientrs sex, age and whether the inner ear is malformed or not. Temporal bone HRCT MPR was applied to analyze the measurement parameter in the standard orientation of the cochlea im- age： the largest distance from the round window to the lateral wall （distance A）, the perpendicular distance （B） and angle of the basal turn of the cochlea relative to the midsagittal plane（γ）. Reproducibility of the measured data was evaluated and the results between the different groups were compared. Result： Measurement of parameter val- ues between the intraobserver and interobserver showed good reproducibility. In normal group, distance A （8.79±0, 34）mm] and perpendicular distance B（6.58 ± 0.28） mm] of males cochleae were significantly larger than A （8.53±0.47）mm] and B （6.22±0.43）mm] of females＇（P〈0.05）, but the angle 7 was not significant- ly different between the two groups（P〉0.05）. The A and B values didn＇t change with age （P〉0.05）, but the angle 7 tended to decrease with increasing age （r= -0.25 ,P〈0.05）. In the malformation group, the value B was significantly smaller than that of the normal group （P〈0.01）, but for value A and angle γ, there was no signifi- cant difference between the two groups （P〉 0.05）. Conclusion： HRCT MPR technique is simple and reliable in mesurement of cochlear morphology. It can be used to guide the surgery and provide an objective basis {or desig- ning the personalized electrode. More clinical application of this technology is recommended.