CAJ | 학술논문

目的对人工耳蜗植入术患者面神经管进行影像学解剖及测量,为术中如何有效避免面神经损伤提供参考.方法人工耳蜗植入术患者35例,术前行128层螺旋CT薄层扫描,后通过多平面重组(MPR)及曲面重建(CPR)技术进行三维重建,参考后鼓室面隐窝入路人工耳蜗植入术面神经相关解剖,重点显示面神经管垂直段与面隐窝、鼓室等结构的相对关系.对颞骨内面神经管各段进行测量,并与35例人工耳蜗植入患者术中测量结果对照.结果 35例患者行128层螺旋CT扫描,MPR及CPR技术三维重建后,能够清晰的显示面神经管各段,其垂直段与外耳道后壁、面隐窝距离分别为(3.31 +0.88)mm、(1.89±0.29)mm,患者术中测量面神经管垂直段与外耳道后壁、面隐窝距离分别为(3.22±0.69)mm、(1.85±0.26)mm,差异无统计学意义(均P＞0.05).35例患者无1例面瘫发生.结论 128层螺旋CT薄扫,结合MPR及CPR技术,可了解面神经管与周围解剖标志的精细关系,可测量面神经管长度,可为人工耳蜗植入、颞骨及其他侧颅底手术如何避免面神经损伤提供依据.
목적 대인공이와식입술환자면신경관진행영상학해부급측량,위술중여하유효피면면신경손상제공삼고.방법 인공이와식입술환자35례,술전행128층라선CT박층소묘,후통과다평면중조(MPR)급곡면중건(CPR)기술진행삼유중건,삼고후고실면은와입로인공이와식입술면신경상관해부,중점현시면신경관수직단여면은와、고실등결구적상대관계.대섭골내면신경관각단진행측량,병여35례인공이와식입환자술중측량결과대조.결과 35례환자행128층라선CT소묘,MPR급CPR기술삼유중건후,능구청석적현시면신경관각단,기수직단여외이도후벽、면은와거리분별위(3.31 +0.88)mm、(1.89±0.29)mm,환자술중측량면신경관수직단여외이도후벽、면은와거리분별위(3.22±0.69)mm、(1.85±0.26)mm,차이무통계학의의(균P＞0.05).35례환자무1례면탄발생.결론 128층라선CT박소,결합MPR급CPR기술,가료해면신경관여주위해부표지적정세관계,가측량면신경관장도,가위인공이와식입、섭골급기타측로저수술여하피면면신경손상제공의거.
Objective To take the imaging anatomy and measurement of facial nerve canal for cochlear implantation patients,and to provide the reference for how to avoid the injury of facial nerve in the opreration.Methods 35 patients which would be given to cochlear implantation were taken 128 thin-slice CT scan preoperative,then using multi planar reformation (MPR) and curved planar reformation (CPR) techniques,the three-dimensional reconstruction were carried out,and referring the facial nerve anatomy of posterior tympanic facial recess approachartificial cochlear implantation,the relationship between the vertical segnent of facial nerve canal and facial recess,tympanic cavity structure was key displayed.The facial nerve canal sections in temporal bone were measured,and compared with measurement results of 35 cases of cochlear implant patients.Results 35 patients underwent 128-slice CT scan three-dimensional reconstruction of MPR and CPR techniques,the facial nerve segment was clearly displayed,and its vertical section of the posterior wall of the external auditory canal,facial recess distance was (3.31 + 0.88)mm,(1.89 + 0.29) mm,respectively,and the vertical segment of the facial nerve canal wall,the facial recess distance of intraoperative measurement was (3.22 + 0.69) mm,(1.85 + 0.26) mm,respectively,and there were.no significant difference between the the both results(all P ＞ 0.05).35 patients had no case of face paralysis.Conclusion 128-slice spiral CT thin scan combined with MPR and CPR techniques can understand the facial nerve canal and surrounding anatomical landmarks of the fine relationship,measurable facial nerve canal length,and provide basis for how to avoid facial nerve injury in the cochlear implant,temporal bone,and the other side of the skull base surgery.