高分辨率颞骨CT对人工耳蜗植入儿童面神经隐窝的测量

目的 通过高分辨率颞骨CT探讨人工耳蜗植入儿童面神经隐窝的解剖及其与圆窗龛的位置关系，从影像学角度为术中面隐窝的解剖提供参考。方法 对78例人工耳蜗植入儿童（154侧耳）的术前高分辨率颞骨CT进行分析，在轴位圆窗龛层面测量以下参数：1. 面神经与外耳道后壁的距离d1；2. 面神经与圆窗龛的距离d2；3. 面神经与圆窗龛的相对角度a；4. 面隐窝中点与圆窗龛的距离d3；5. 面隐窝中点与圆窗龛的相对角度b。记录可能影响面隐窝解剖的因素，包括患儿的性别、年龄以及HRCT上的解剖变异（如乳突气化类型、乙状窦前移、颈静脉球高位、前庭水管扩张等），并分析以上因素与测得面隐窝参数的相关性。结果 面-壁距d1平均值为(4.21±0.69)mm，面-龛距d2平均值为(5.95±0.62)mm，面-龛角a平均值为(94.61±9.04)°，窝-龛距d3平均值为(6.46±0.63)mm，窝-龛角b平均值为(113.47±7.83)°。患儿的性别、年龄以及乙状窦前移3个因素对面隐窝宽度d1有影响，前庭水管扩大对面神经相对圆窗龛的角度a和面隐窝相对圆窗龛的角度b有影响。结论 人工耳蜗植入术前高分辨率颞骨CT可以显示面神经隐窝的重要解剖关系，测量结果对人工耳蜗植入手术操作具有临床参考价值。

Measurement of facial recess in children with cochlear implant by high resolution temporal bone CT#br#

Objective To study the anatomy of facial recess(FR) and the relationship between the position of FR and the round window niche(RWN) in children who need cochlear implant by high resolution temporal bone CT.Methods Seventy-eight children (154 ears) with cochlear implant were analyzed with preoperative high-resolution temporal bone CT. The following parameters were measured at the RWN level of axial CT scan: 1. The distance between the facial nerve(FN) and the posterior wall of the external auditory canal (d1); 2. The distance between FN and RWN (d2); 3. The relative angle between FN and RWN (a); 4. The distance between the midpoint of FR and RWN (d3); 5. The relative angle between the midpoint of FR and RWN (b). The factors that might affect the anatomy of FR were recorded, including sex, age, and the anatomical variation on HRCT (such as the type of mastoid gasification, the position of sigmoid sinus and jugular bulb, the expansion of vestibular aqueduct). The correlation between the above factors and the measurements of FR was analyzed.Results The distance d1 was (4.21±0.69) mm, the distance d2 was (5.95±0.62) mm, the angle a was (94.61±9.04)°, the distance d3 was (6.46±0.63) mm, the angle b was (113.47±7.83)°. The width of FR (d1) was affected by three factors: age, gender and anteversion of sigmoid sinus. The angle a and the angle b were affected by expansion of vestibular aqueduct.Conclusion High resolution CT of temporal bone before cochlear implantation can show the important anatomical relationship of FR, and the measurements can be of clinical reference value for cochlear implant surgery.