多层螺旋CT面神经管曲面重建应用于中耳手术中的解剖学研究

目的探讨多层螺旋CT（muhislice spiral CT，MSCT）面神经管曲面重建（curved planar reformation，CPR）在中耳乳突手术中的应用。方法成人尸头标本20具，行颞骨MSCT超薄层高分辨率扫描，在3个垂直平面上分别进行面神经管CPR重建，在重建图像上测量面神经管与各外科解剖标志结构间的距离，并与标本测量结果进行对照。结果（1）外半规管与面神经管关系在横断面重建CPR像上显示最好，壶腹部与面神经管间距离最短，为（1．74±0．29）mm，外半规管后缘与面神经管锥曲处间距离最大，为（2．47±0．51）mm。（2）砧骨短脚窝形态在矢状面重建CPR像上显示最佳，与面神经管锥曲最短距离为（2．88±0．41）mm。（3）乙状窦沟在冠状面重建CPR像上显示最好，与面神经管最短距离为（8．97±2．72）mm。CPR像上各测量值与解剖标本测量值差异均无统计学意义（P〉0．05）。结论MSCT面神经管CPR重建可用于测量面神经管与外科标志性结构间的距离，为术中面神经的保护发挥重要作用。（中国眼耳鼻喉科杂志，2009，9：89-91）

Anatomical study on the application of multislice spiral CT curved planar reformation of the facial nerve canal in middle ear surgery

Objective To investigate the value of the muhislice spiral CT （MSCT） curved planar reformation （CPR） of the facial nerve canal in otological surgery. Methods Twenty heads of adult cadavers with 40 temporal bone were scanned by MSCT with ultrathin slice high resolution. The facial nerve canal CPR images were reconstructed based on three orthogonal planes. The distances between the facial nerve canal and the surgical landmarks were measured on the CPR images and correlated with those of cadavers. Results （ 1 ） The lateral semicircular canal was displayed soundly on the axial based CPR image. The minimal distance was （ 1.74± 0.29） mm which was manifested between the facial nerve canal and the ampulla of lateral semicircular canal. The maximal distance was （2.47±0.50）mm which was found between the second genu of the facial nerve canal and posterior margin of the lateral semicircular canal. （2）The fossa of the incudal short process was displayed best on the sagittal based CPR image which was similar with the specimen. The shortest distance to the second genu of the facial nerve canal was （ 2.88± 0.40 ） mm. （ 3 ） The sigmoid sinus was displayed on the coronal based CPR image with the shortest distance to the facial nerve canal of （8.97 ± 2.72） ram. There was no statistical difference between the measurements of CPR images and those of specimens （ P 〉 0.05 ）. Conclusions MSCT CPR of the facial nerve canal was accurate in demonstrating the distance between the surgical landmark and the facial nerve canal; thus it was helpful for decreasing the surgical injury of the facial nerve. （Chin J Ophthalmol and Otorhinolaryngo1,2009,9：89-91 ）