基于磁共振数据的三维半规管建模空间方向测量

目的测量半规管相互夹角和空间方向。方法对16例磁共振3D-CISS序列内耳检查影像,分割半规管结构建立三维模型,生成3D PDF文件,在各半规管取3点坐标,通过数学方法对同侧和双侧的半规管相互夹角以及各半规管和水平面的夹角进行计算。结果左右后半规管夹角为98.49°±12.07°,可以推测后半规管和矢状面的夹角为49.25°±6.04°。左右水平半规管夹角为171.58°±3.78°;左侧后半规管和右侧前半规管夹角为165.56°±5.78°,右侧后半规管和左侧前半规管夹角为164.74°±6.46°,左侧水平半规管和水平面夹角为19.43°±3.02°,右侧水平半规管和水平面夹角22.11°±4.12°。结论左右共同平面对半规管近乎平行,后半规管和矢状面的夹角大于45°,两侧半规管总脚分叉点和眼球下缘平面更加接近水平面。     

成人颞骨骨迷路的解剖学研究及其临床意义

目的:对成人颞骨骨迷路进行解剖观察和测量,为临床提供解剖学基础。方法:制作26侧成人颞骨骨迷路标本进行观察和测量。结果:(1)半规管长度以后半规管最长,前半规管次之,外半规管最短。(2)半规管横断面呈椭圆形,其弓顶处管腔纵径大于横径。(3)壶腹端、单脚端、总脚端均近似圆形。后、前、外半规管壶腹端的纵径分别为:1.94mm,1.95mm,1.92mm。外半规管单脚端纵径为1.20mm,前、后半规管总脚端纵径为1.60mm。(4)三个半规管弓除外半规管弓在同一平面上外,前、后半规管弓均不在同一平面上,而呈不同程度的扭曲。(5)同侧三半规管之间并非相互垂直。(6)26侧中前半规管位于弓状隆突下的有16侧(61.54％),余10侧(38.46％)与弓状隆突不相重叠。结论:本研究结果为骨迷路结构研究增添了新的内容,为临床内耳手术的开展提供解削学基础和参考数据。     

后半规管非平面性对夹角测量的影响

目的 测量后半规管夹角,观察后半规管非平面性对夹角测量的影响。 方法 对20例磁共振三维稳态构成干预序列内耳检查影像进行分析,通过使用3D Slicer 4.4软件直接测量左、右后半规管的夹角来推算后半规管和矢状面的夹角。 结果 左、右后半规管夹角为90.5°±8.9°,最小夹角73°,最大夹角108°。可推算后半规管和矢状面夹角为45.3°±4.4°,最小36.5°,最大54°。 结论 后半规管切面经过或不经过共脚,由此导致夹角测量差异约为9°,故此次测量数据和既往研究相符,但本方法更加直观方便。     

上半规管良性阵发性位置性眩晕诊断试验分析和物理引擎耳石运动观察

目的 对上半规管良性阵发性位置性眩晕（BPPV）诊断试验进行分析，了解其诊断机制。方法 建立标准空间坐标系的膜迷路模型，设定膜迷路不同位置结石，基于物理引擎三维物理仿真，分析Dix Hallpike试验和仰卧悬挂头位试验耳石运动情况，进而推断所诱发眼震表现。结果 Dix-Hallpike试验和仰卧悬挂头位试验所有位置的结石都有一定程度的运动，并能诱发椭圆囊的结石经总管进入半规管。出现下跳眼震的情况，包括结石从椭圆囊进入后半规管，对侧后半规管结石向壶腹运动，上半规管的结石从壶腹嵴帽底部滑动到顶部，后者重复诊断实验仍为下跳眼震。重复10次观察，试验结果一致。结论 对于上半规管BPPV的诊断标准，还需要重新评估，观察眼震动态变化是必要的，其诊断方法需要改良。     

面神经隐窝径路手术剖面观察及多层螺旋CT双斜矢状位多平面重建

目的 通过显微解剖观察面神经隐窝径路手术中涉及到的关键手术剖面及解剖标志,利用多层螺旋CT双斜矢状位多平面重建技术,探讨面神经隐窝径路关键手术剖面主要解剖标志同层显示的可行性及意义.方法 在尸体头颅标本上模拟面神经隐窝手术径路,观察手术中涉及到的关键手术剖面及解剖标志.利用多层螺旋CT双斜矢状位多平面重建技术,对80例患者进行面神经隐窝径路中关键手术剖面重建观察,其中成人55例(110耳),儿童25例(50耳),对4个不同方位图像(横断位、冠状位、矢状位及双斜矢状位)同层显示解剖标志的程度进行分级评价.对重要解剖标志与周围重要结构的距离进行影像学测量,比较不同年龄组的测量值有无差异.结果 面神经隐窝入路手术中涉及到4层关键手术剖面,其方位均为双斜矢状位.4层关键手术剖面双斜位多平面重建图像中主要解剖标志同层显示程度均优于横断位、冠状位及矢状位,同层显示成功率均为100%.水平半规管上缘中点与中颅窝脑板的垂直距离、乙状窦最前缘与外耳道后壁前缘的垂直距离在不同年龄组间的差异有统计学意义(P＜0.05),儿童小于成人.面神经水平段下缘与前庭窗下缘之间的垂直距离及乳突段前缘与圆窗龛后外缘之间的垂直距离在不同年龄组间的差异无统计学意义(P＞0.05).结论 多层螺旋CT双斜矢状位多平面重建技术可清晰同层显示面神经隐窝径路手术剖面相关解剖标志,结合手术入路及手术目的,有针对性地进行手术剖面双斜位多平面重建及测量,能为术者提供更有实用价值的影像学信息.     

部分迷路切除对桥小脑角区显露及其损伤程度的评价

目的:对迷路入路对桥小脑角区的显露程度及其损伤程度进行定量综合评价.方法:通过对成年国人带颈头颅标本6具(12侧),模拟常规的经迷路入路的手术操作,在迷路后入路的基础上,分别磨除部分半规管(上半规管和后半规管)和全部半规管.每个手术步骤完成后,按Ammirat标准进行评价不同手术入路及其扩大后对桥小脑角区的显露程度,用Horgan法计算出显露面积,并根据损伤程度评分评价3种手术入路及其扩大后的损伤程度.结果:经迷路后入路及其磨除部分半规管和全部半规管的显露程度评分分别为1分、1分和2分,显露面积分别为(304.29±39.74)mm<'2>、(416.13±90.14)mm<'2>和(610.47±109.36)mm<'2>,磨除部分半规管后显露面积较迷路后入路明显增加(P<0.001),而磨除全部半规管后显露面积较磨除部分半规管无显著扩大(P=0.562).而经迷路后入路及其磨除部分半规管和全部半规管的损伤程度评分分别为1分、9分和12分.结论:单纯迷路后入路对桥小脑角区显露有限,在单纯迷路后入路的基础上磨除部分半规管(上半规管和后半规管),对桥小脑角区的显露程度和显露面积明显扩大,但相应的损伤程度扩大,磨除全部半规管较磨除部分迷半规管路并不能明显扩大显露程度和显露面积,且损伤程度明显扩大.     

半规管与动物敏捷度

正半规管是脊椎动物内耳的一个古老组成部分。在有颌动物(有颌骨的脊椎动物)的听泡中,骨性管道和其中的膜性管道组成了半规管,每侧听泡中各有上、外、后3个半规管,代表空间3个不同的平面,分别感受运动过程中头部在不同方向的旋转~([1])。大脑将半规管的传人冲动与耳石、视觉和本体感觉的信息进行整合分析,进而调整运动过程中躯体的姿势和动作~([2])。注视锁定是半规管最重要的功能之一,这一功能是通过前庭眼反射和前庭丘反射实现的,在运动中眼外肌和颈部肌肉需要配合躯体     

颞骨内面神经垂直段的显微解剖及其临床意义

目的：研究颞骨内面神经垂直段及其毗邻结构的显微解剖,为临床应用提供解剖学资料。方法：通过模拟临床经乳突入路的方法,分层解剖20个成人湿性头颅标本（40侧颞骨）,显露并观测颞骨内面神经垂直段及其毗邻结构。结果：面神经垂直段的长度为（17.39±1.78）mm、直径为（2.13±0.13）mm,面神经垂直段与水平段的夹角（向前）为（115.5±6.89）°,面神经垂直段近端至外半规管隆突距离为（2.86±0.31）mm,鼓索神经自面神经发出点至茎乳孔距离为（5.99±0.74）mm,面神经垂直段与鼓索神经的夹角（向上）为（38.6±1.99）°,锥隆起尖到面神经垂直段垂直距离为（2.05±0.65）mm,后半规管至面神经垂直段最短距离为（2.89±0.36）mm。有5%（2/40侧）的面神经垂直段的近端位于外半规管隆突外侧。结论：外半规管、鼓索神经、茎乳孔、锥隆起、后半规管是手术中确定面神经垂直段的重要标志。熟悉颞骨内面神经垂直段与其周围结构的毗邻关系,有利于面神经垂直段相关手术的顺利进行。     

乙状窦前迷路后入路中后骨半规管定位与保护的应用解剖

目的:为乙状窦前入路中安全磨出半规管提供解剖学资料。方法:经10%福尔马林溶液固定的成人尸头标本15个共30侧。磨除Trautman三角的骨质,暴露乙状窦、岩上窦、岩上窦-乙状窦交点、上骨半规管及面神经垂直段、颈静脉球,测量后骨半规管与毗邻结构的距离。结果:后骨半规管与硬化型的乳突对后骨半规管的安全磨出影响较大。鼓室窦存在率100%。后骨半规管的定位:骨质的改变;乙状窦前含乳突小房的松质骨中出现致密的象牙骨质提示接近后骨半规管;颅后窝硬膜皱褶自乙状窦向深层汇集点,提示接近后骨半规管;鼓室窦暴露后,通过外骨半规管定位后骨半规管。结论:鼓室窦可以定位外骨半规管,继而定位后骨半规管;明确毗邻的结构关系可以为安全磨出后骨半规管提供保证。     

颅中凹进路内耳道定位研究

采用50侧成年头部标本,经颅中凹手术进路,以棘孔的胸膜中动脉、面神经管裂孔和上半规管拱峰为标志,对内耳道的位置进行确定。观测棘孔至面神经管裂孔的距离、面神经管裂孔至内耳道底面神经管内口的距离。膝状神经节裸露率,弓状隆起与上半规管拱峰的关系、上半规管拱峰至内耳道后壁的距离、内耳道上壁至岩上窦的距离,内耳道内上方骨突率,并提出不同手术应采取不同的标志对内耳道进行定位。     

A Morphometric Study of the Semicircular Canals Using Micro‐CT Images in Three‐Dimensional Reconstruction

It is generally accepted that the three semicircular canals are set at right angles to each other and the lateral semicircular canal is smaller than the anterior and posterior semicircular canals. Precise knowledge of the size and spatial relationships of the semicircular canals is vital, and so the 40 petrous parts of the temporal bones were scanned by micro‐CT at a slice thickness of 35 µm. The micro‐CT images were used in reconstructing three‐dimensional models of the bony labyrinth using computer software. Various dimensions of the semicircular canals were measured using the software, and statistical analysis was performed. The anterior semicircular canal was slightly wider than the posterior semicircular canal, and their heights were similar. The radius of curvature of the lateral semicircular canal was 20% smaller than those of the anterior and posterior semicircular canals. The angles between the three canals were not exactly 90 degrees: they were 92.1, 84.4, and 86.2 degrees between the anterior and posterior, anterior and lateral, and posterior and lateral semicircular canals, respectively. We obtained high‐resolution images of the semicircular canals using three‐dimensional reconstruction software, and these were used to precisely measure the angles between the semicircular canals and the area of the distorted circle formed by each semicircular canal. Anat Rec, 296:834–839, 2013. © 2013 Wiley Periodicals, Inc.     

颅底外面部分骨性标志三维坐标值及其意义

目的 :探讨测量颅底外面解剖结构三维空间坐标的方法并为临床应用提供相关数据。方法 :建立与颅底内面相统一的三维空间坐标系 ,在特制颅器上以 3 2个成年国人水平锯开颅骨标本为测量对象。结果 :测出了颅底外面骨性标志 2 1项共 3 4个测点的三维空间坐标值 ;可准确地测算出各测点在颅表各个方位的投影点和深度 ;根据坐标值和解析几何公式 ,还可推算出所有测点间连线 (线段 )的距离 (测距 )及其与三个基准坐标面的角度 (测角 )。结论 :明确了颅底外面各测点的空间位置和颅底内外两面任何测点间的位置关系 ,为颅底手术定位或放疗照射野等定位设计 ,提供了更为简便可靠的新方法。     

A quantitative analysis of the spatial organization of the vestibulo-ocular reflexes in lateral- and frontal-eyed animals--I. Orientation of semicircular canals and extraocular muscles

The spatial relationship between extraocular muscles and semicircular canals was evaluated in cat (frontal-eyed animal) and rabbit (lateral-eyed animal). Semicircular canal orientations in the rabbit were determined by a principal components analysis of data points obtained from the exposed osseous canals using a three-axis micromanipulator. Canal orientations were presented in terms of unit sensitivity vectors. Orientation of extraocular muscles in rabbits and cats was derived from measurements of the insertion and origin of each muscle with respect to a reference point on the skull and a calculated estimate of the center of the eye. Muscle orientations were presented in terms of unit action vectors. Semicircular canal planes of the rabbit labyrinth were not orthogonal, having deviations up to 14 degrees. Pairs of antagonistically acting vertical semicircular canals, left (right) anterior-right (left) posterior deviated from coplanarity by 16 degrees, while the deviation for the horizontal canals was 9 degrees. In both animals, muscles of an antagonistic pair were coplanar to within 8 degrees, with the exception of the oblique muscles in the rabbit for which the deviation was 19 degrees. The three pairs of antagonistic muscles were almost orthogonal to each other, the maximum deviation between any of the pairs being 8 degrees in the cat and 18 degrees in the rabbit. Comparing extraocular muscle planes and semicircular canal planes reveals that they are roughly aligned. However, there were slight but consistent differences between a given semicircular canal plane and the planes of the muscles to which this canal is connected by the classical three-neuron-arc (principal vestibulo-ocular reflex circuits).(ABSTRACT TRUNCATED AT 250 WORDS)     

Geometry of the semicircular canals and extraocular muscles in rodents,lagomorphs, felids and modern humans

The vestibulo‐ocular reflex (VOR) exacts compensatory movements of the extraocular muscles in response to stimulation of the semicircular canals to allow gaze fixation during head movements. In this study, the spatial relationships of these muscles and canals were investigated to assess their relative alignments in mammalian species commonly used in studies of the VOR. The head region of each specimen was scanned using magnetic resonance imaging and 28 anatomical landmarks were recorded from the images to define the six extraocular muscles and the anatomical planes of the three semicircular canals. The vector rotation of a semicircular canal that does not stimulate either of its two sister canals, referred to as the prime direction, was also calculated as an estimate of the maximal response plane. Significant misalignments were found between the extraocular muscles and the canals by which they are principally stimulated in most of the species under study. The deviations from parallel orientation were most pronounced in the human and rabbit samples. There were also significant departures from orthogonality between the semicircular canals in most species. Only the guinea pig displayed no significant difference from 90° in any of its three inter‐canal angles, although humans and rabbits deviated from orthogonality in just one semicircular canal pair – the anterior and posterior canals. The prime directions were found to deviate considerably from the anatomical canal planes (by over 20° in rats). However, these deviations were not always compensatory, i.e. prime planes were not always more closely aligned with the muscle planes. Results support the view that the vestibular frame remains relatively stable and that the spatial mismatch with the extraocular co‐ordinate frame is principally driven by realignment of the muscles as a result of changes in the position of the orbits within the skull (orbital convergence and frontation).     

Comparative analysis of vestibular ecomorphology in birds

The bony labyrinth of vertebrates houses the semicircular canals. These sense rotational accelerations of the head and play an essential role in gaze stabilisation during locomotion. The sizes and shapes of the semicircular canals have hypothesised relationships to agility and locomotory modes in many groups, including birds, and a burgeoning palaeontological literature seeks to make ecological interpretations from the morphology of the labyrinth in extinct species. Rigorous tests of form–function relationships for the vestibular system are required to support these interpretations. We test the hypothesis that the lengths, streamlines and angles between the semicircular canals are related to body size, wing kinematics and flying style in birds. To do this, we applied geometric morphometrics and multivariate phylogenetic comparative methods to a dataset of 64 three‐dimensional reconstructions of the endosseous labyrinth obtained using micro‐computed tomography scanning of bird crania. A strong relationship between centroid size of the semicircular canals and body size indicates that larger birds have longer semicircular canals compared with their evolutionary relatives. Wing kinematics related to manoeuvrability (and quantified using the brachial index) explain a small additional portion of the variance in labyrinth size. We also find strong evidence for allometric shape change in the semicircular canals of birds, indicating that major aspects of the shape of the avian labyrinth are determined by spatial constraints. The avian braincase accommodates a large brain, a large eye and large semicircular canals compared with other tetrapods. Negative allometry of these structures means that the restriction of space within the braincase is intense in small birds. This may explain our observation that the angles between planes of the semicircular canals of birds deviate more strongly from orthogonality than those of mammals, and especially from agile, gliding and flying mammals. Furthermore, we find little support for relationships between labyrinth shape and flying style or wing kinematics. Overall, our results suggest that the topological problem of fitting long semicircular canals into a spatially constrained braincase is more important in determining the shape of the avian labyrinth than the specifics of locomotory style or agility. Our results tentatively indicate a link between visual acuity and proportional size of the labyrinth among birds. This suggests that the large labyrinths of birds compared with other tetrapods may result from their generally high visual acuities, and not directly from their ability to fly. The endosseous labyrinths of extinct birds and their close dinosaurian relatives may allow broad inferences about flight or vision, but so far provide few specific insights into detailed aspects of locomotion.     

Three-dimensional spatial characteristics of caloric nystagmus

We investigated the three-dimensional spatial characteristics of caloric nystagmus during excitation and inhibition of the lateral semicircular canal in five normal human subjects. Each subject was repositioned in 45 degrees steps at 1-min intervals such that the right lateral semicircular canal plane was reoriented in pitch, from 135 degrees backwards from the upright position to 135 degrees forwards, while the right ear was continuously stimulated with air at 44 degrees C. In orientations in which caloric stimulus resulted in excitation of the right lateral semicircular canal, the eye velocity axis was orthogonal to the average orientation of the right lateral semicircular canal plane. However, in orientations in which caloric stimulus resulted in inhibition of the right lateral semicircular canal, the eye velocity axis was orthogonal to the average orientation of the left and not the right lateral semicircular canal plane. These findings suggest that velocity and direction of caloric nystagmus depend not only on the absolute magnitude of vestibular activity on the stimulated side but also on the differences in activity between the left and right vestibular nuclei, most probably mediated centrally via brainstem commissural pathways.     

Response of vestibular neurons to head rotations in vertical planes. I. Response to vestibular stimulation

1. We have studied, in decerebrate cats, the responses of neurons in the lateral and descending vestibular nuclei to whole-body rotations in vertical planes that activated vertical semicircular canal and utricular receptors. Some neurons were identified as vestibulospinal by antidromic stimulation with floating electrodes placed in C4. 2. The direction of tilt that caused maximal excitation (response vector orientation) of each neuron was determined. Neuron dynamics were then studied with sinusoidal stimuli closely aligned with the response vector orientation, in the range 0.02-1 Hz. A few cells, for which we could not identify a response vector, probably had spatial-temporal convergence. 3. On the basis of dynamics, neurons were classified as receiving their input primarily from vertical semicircular canals, primarily from the otolith organs, or from canal+otolith convergence. 4. Response vector orientations of canal-driven neurons were often near +45 degrees or -45 degrees with respect to the transverse (roll) plane, suggesting these neurons received excitatory input from the ipsilateral anterior or posterior canal, respectively. Some neurons had canal-related dynamics but vector orientations near roll, presumably because they received convergent input from the ipsilateral anterior and posterior canals. Few neurons had their vectors near pitch. 5. In the lateral vestibular nucleus, neurons with otolith organ input (pure otolith or otolith+canal) tended to have vector orientations closer to roll than to pitch. In the descending nucleus the responses were evenly divided between the roll and pitch quadrants. 6. We conclude that most of our neurons have dynamics and response vector orientations that make them good candidates to participate in vestibulospinal reflexes acting on the limbs, but not those acting on the neck.     

颅底曲度与后牙牙合平面倾斜度对矢状骨面型形成的影响

文题释义： 矢状骨面型：矢状向上，上下颌骨的位置关系及其所导致的错牙合畸形类型。 牙合 平面：由连接上下颌切牙覆牙合中点、上下颌第1磨牙覆牙合中点确定的假想平面。 后牙牙合平面：由连接上颌第2前磨牙颊尖和上颌第2磨牙或第3磨牙(如果萌出)颊尖的假想平面。 背景：研究表明颅底角与矢状骨面型的形成有关，牙合平面或后牙牙合平面对矢状骨面型形成的影响也存在一定的争议。 目的：比较牙合平面倾斜度与后牙牙合平面倾斜度在决定矢状骨面型形成中的重要性，探讨颅底曲度、后牙牙合平面倾斜度对矢状骨面型形成的综合效应，及两者之间的相关性。 方法：研究方案的实施符合西南医科大学附属口腔医院的相关伦理要求，患者及监护人对测量过程均知情同意，并签署了知情同意书。选择符合纳入标准的207名个体的头颅侧位片(男100例，女107例，年龄12-20岁)，利用Uceph 软件、SPSS软件(版本17.0)进行相关指标的测量和分析。按照前后不调指数(APDI)值将样本的矢状骨面型分为3组：Ⅱ类组、Ⅰ类组、Ⅲ类组。SNK、LSD 法比较各项相关指标在3组之间的差异。运用Pearson积矩相关系数分析法对颅底角(NSBa角)、牙合平面(FH-OP)、后牙牙合平面(FH-POP)与其他相关测量指标的相关性进行分析。根据牙合平面倾斜度、后牙牙合平面倾斜度及颅底角进行分组，并运用成组t检验法分别对相关骨性与牙性指标的进行比较。根据后牙牙合平面角度和颅底角度建立4个牙齿骨骼型组：小颅底角-平坦后牙合平面组(S-F)，小颅底角-陡峭后牙合平面组(S-S)，大颅底角-平坦后牙合平面组(L-F)，大颅底角-陡峭后牙合平面组(L-S)。应用交叉单因素方差分析法进行各组间差异的比较。 结果与结论：①Ⅲ类错牙合畸形患者的颅底角明显小于Ⅰ类和Ⅱ类，而Ⅱ类错牙合患者的后牙牙合平面明显大于Ⅲ类和Ⅰ类；②代表矢状骨面型分类的指标(APDI及ANB角)在牙合平面倾斜组之间并未发现差异；③颅底角和后牙牙合平面交叉分组的比较中，只有小颅底角-平坦后牙牙合平面组和大颅底角-陡峭后牙牙合平面组间的比较结果显示ANB角和APDI值存在显著差异；④结果说明，对于影响矢状骨面型的形成的因素中，后牙合平面比牙合平面更具代表性；颅底角度和牙合平面倾斜度作为单独的指标在确立前后骨骼畸形方面存在局限性；颅底曲度和后牙合平面倾斜共同影响矢状骨面型的形成；在矢状骨面型形成过程中，颅底曲度及后牙合平面之间可能存在一定的补偿机制。 ORCID: 0000-0002-1930-6566(余星月)；0000-0002-2386-6515(程钎) 中国组织工程研究杂志出版内容重点：组织构建；骨细胞；软骨细胞；细胞培养；成纤维细胞；血管内皮细胞；骨质疏松；组织工程