中华解剖与临床杂志
中華解剖與臨床雜誌
중화해부여림상잡지
Chinese Journal of Anatomy and Clinics
2014年
2期
89-92
,共4页
陈克光%吕慧英%戴培东%杨琳%张天宇
陳剋光%呂慧英%戴培東%楊琳%張天宇
진극광%려혜영%대배동%양림%장천우
人工中耳%圆窗龛%外耳道狭窄%外耳道闭锁
人工中耳%圓窗龕%外耳道狹窄%外耳道閉鎖
인공중이%원창감%외이도협착%외이도폐쇄
Middle ear implant%Round window niche%Congenital external auditory canal stenosis%Congenital aural atresia
目的 通过研究先天性外耳道狭窄、先天性外耳道闭锁患者圆窗龛及其附近龛外窝形态的差异,获得圆窗龛及龛外窝形态的参数,为人工中耳圆窗振子的外形设计及其在圆窗龛植入时的安全放置提供依据.方法 将17例(20侧耳)先天性外耳道狭窄患者(狭窄组,男9例、女8例,年龄7～28岁)、15例(20侧耳)先天性外耳道闭锁患者(闭锁组,男9例、女6例,年龄4～27岁)和10例健康人(健康对照组,20侧耳,男5例、女5例,年龄12 ～60岁)的颞骨CT序列图像导入Mimics软件,在3D重建基础上读取圆窗龛及其附近龛外窝相关标志点的三维坐标,基于Matlab软件编制程序计算圆窗龛龛口前后、上下径,圆窗前后、内外径,圆窗龛前、后、上、下各壁长度,圆窗龛深度,龛外窝深度及大小,对数据进行统计分析.结果 闭锁组圆窗龛前、后壁长度分别为(1.48 ±0.26) mm和(2.28±0.56) mm,狭窄组分别为(1.32 ±0.36)mm和(1.99±0.58)mm,健康对照组分别为(0.96 ±0.33)mm和(1.55±0.53)mm,差异均有统计学意义(P值均＜0.05);闭锁组圆窗龛上壁长度(1.29 ±0.32) mm,大于健康对照组的(1.00 ±0.33) mm(P ＜0.05);闭锁组的龛外窝大小小于狭窄组,狭窄组小于健康对照组,差异均有统计学意义(P值均＜0.05).龛外窝深度在3组间比较差异均无统计学意义(P值均＞0.05).结论 随着外耳道畸形程度加重,圆窗龛前、后、上壁有变长趋势,龛外窝有变小的趋势.该结果可为人工中耳圆窗振子的设计及先天性外耳道狭窄和闭锁患者圆窗振子植入的手术设计提供依据.
目的 通過研究先天性外耳道狹窄、先天性外耳道閉鎖患者圓窗龕及其附近龕外窩形態的差異,穫得圓窗龕及龕外窩形態的參數,為人工中耳圓窗振子的外形設計及其在圓窗龕植入時的安全放置提供依據.方法 將17例(20側耳)先天性外耳道狹窄患者(狹窄組,男9例、女8例,年齡7～28歲)、15例(20側耳)先天性外耳道閉鎖患者(閉鎖組,男9例、女6例,年齡4～27歲)和10例健康人(健康對照組,20側耳,男5例、女5例,年齡12 ～60歲)的顳骨CT序列圖像導入Mimics軟件,在3D重建基礎上讀取圓窗龕及其附近龕外窩相關標誌點的三維坐標,基于Matlab軟件編製程序計算圓窗龕龕口前後、上下徑,圓窗前後、內外徑,圓窗龕前、後、上、下各壁長度,圓窗龕深度,龕外窩深度及大小,對數據進行統計分析.結果 閉鎖組圓窗龕前、後壁長度分彆為(1.48 ±0.26) mm和(2.28±0.56) mm,狹窄組分彆為(1.32 ±0.36)mm和(1.99±0.58)mm,健康對照組分彆為(0.96 ±0.33)mm和(1.55±0.53)mm,差異均有統計學意義(P值均＜0.05);閉鎖組圓窗龕上壁長度(1.29 ±0.32) mm,大于健康對照組的(1.00 ±0.33) mm(P ＜0.05);閉鎖組的龕外窩大小小于狹窄組,狹窄組小于健康對照組,差異均有統計學意義(P值均＜0.05).龕外窩深度在3組間比較差異均無統計學意義(P值均＞0.05).結論 隨著外耳道畸形程度加重,圓窗龕前、後、上壁有變長趨勢,龕外窩有變小的趨勢.該結果可為人工中耳圓窗振子的設計及先天性外耳道狹窄和閉鎖患者圓窗振子植入的手術設計提供依據.
목적 통과연구선천성외이도협착、선천성외이도폐쇄환자원창감급기부근감외와형태적차이,획득원창감급감외와형태적삼수,위인공중이원창진자적외형설계급기재원창감식입시적안전방치제공의거.방법 장17례(20측이)선천성외이도협착환자(협착조,남9례、녀8례,년령7～28세)、15례(20측이)선천성외이도폐쇄환자(폐쇄조,남9례、녀6례,년령4～27세)화10례건강인(건강대조조,20측이,남5례、녀5례,년령12 ～60세)적섭골CT서렬도상도입Mimics연건,재3D중건기출상독취원창감급기부근감외와상관표지점적삼유좌표,기우Matlab연건편제정서계산원창감감구전후、상하경,원창전후、내외경,원창감전、후、상、하각벽장도,원창감심도,감외와심도급대소,대수거진행통계분석.결과 폐쇄조원창감전、후벽장도분별위(1.48 ±0.26) mm화(2.28±0.56) mm,협착조분별위(1.32 ±0.36)mm화(1.99±0.58)mm,건강대조조분별위(0.96 ±0.33)mm화(1.55±0.53)mm,차이균유통계학의의(P치균＜0.05);폐쇄조원창감상벽장도(1.29 ±0.32) mm,대우건강대조조적(1.00 ±0.33) mm(P ＜0.05);폐쇄조적감외와대소소우협착조,협착조소우건강대조조,차이균유통계학의의(P치균＜0.05).감외와심도재3조간비교차이균무통계학의의(P치균＞0.05).결론 수착외이도기형정도가중,원창감전、후、상벽유변장추세,감외와유변소적추세.해결과가위인공중이원창진자적설계급선천성외이도협착화폐쇄환자원창진자식입적수술설계제공의거.
Objective To investigate the morphological difference of round window niche and outside fossa among the congenital aural atresia,the external auditory canal stenosis and the normal controls in order to obtain the reference value and provide the basis for the design and safe implantation of the transducer in the area of round window niche.Methods CT serial images of 20 ears of 10 health subjects including 5 males and 5 females aged 12 to 60 years,20 ears of 17 external auditory canal stenosis subjects including 9 males and 8 females aged 7 to 28 years,and 20 ears of 15 congenital aural atresia subjects including 9 males and 6 females aged 4 to 27 years were imported into Mimics software for image processing.Three-dimensional coordinate values of landmarks of the round window niche and outside fossa were acquired.Then,anteroposterior diameter and suprainferior diameter of the round window niche opening,anteroposterior diameter and medial-lateral diameter of the round window,anterior wall,posterior wall,superior wall,inferior wall of the round window niche,the depth of round window niche and outside fossa,and the size of outside fossa were calculated by Matlab software.Finally,the data were analyzed statistically.Results The length of the anterior and posterior walls of the round window niche of atresia group [(1.48 ± 0.26) mm,(2.28 ± 0.56) mm] were found to be greater than those of stenosis group [(1.32 ± 0.36) mm,(1.99 ± 0.58) mm] (P ＜0.05),and their values of stenosis group were greater than those of health group [(0.96 ± 0.33) mm,(1.55 ±0.53) mm] (all P values ＜ 0.05).The length of superior wall of the round window niche of atresia group (1.29 ± 0.32) mm was greater than that of health group [(1.00 ± 0.33) mm] (P ＜ 0.05).The size of outside fossa of atresia group was smaller than stenosis group(P ＜0.05),and the size of stenosis group was smaller than that of health group (all P values ＜ 0.05).There was no statistical significant difference of the outside fossa depth among different groups (all P values ＞ 0.05).Conclusions With the aggravation of the external auditory canal malformation,anterior wall,posterior wall,as well as superior wall of the round window niche got longer and the size of outside fossa will get smaller,this paper provides novel information for the better design,selecting and safer implantation of the transducer in the area of round window niche.
