慢性中耳乳突炎伴鼓室骨壁损害HRCT特征及临床价值探析.doc

慢性中耳乳突炎伴鼓室骨壁损害HRCT特征及临床价值探析 　【摘要】 　　目的　探讨慢性中耳乳突炎损害鼓室壁的HRCT特征及其临床价值。方法对28例32耳慢性中耳乳突炎的影像资料进行回顾性分析。结果(1)鼓室盖异常8耳占25%,其中骨质疏松2耳，骨壁菲薄1耳，骨壁缺损5耳；(2)颈动脉管异常6耳占18.7%,其中骨质疏松2耳，骨质硬化3耳，骨壁缺损1耳；(3)颈静脉孔壁异常5耳占15.6%,其中骨质疏松2耳，骨壁菲薄1耳，骨壁缺损2耳；(4)乙状窦骨壁异常13耳占40.6%,其中乙状窦骨壁缺损3耳，乳突窦骨壁破坏10耳，听小骨缺损、移位5耳；(5)骨迷路异常7耳占21.8%,其中鼓岬缺损1耳，前庭窗模糊1耳，蜗窗缺损2耳，面神经管缺损2耳，外半规管缺损1耳；(6)鼓膜异常21耳占65.6%,其中鼓膜缺损7耳，鼓膜增厚7耳，鼓膜内陷5耳，外耳道骨质破坏2耳。结论运用HRCT扫描横断位和冠状位相结合，除能显示慢性中耳乳突炎病变征象外，还能确定其鼓室各壁的骨质损害部位、程度及与周围结构的关系，对手术处理具有重要意义。 【关键词】 中耳乳突炎；鼓室壁；高分辨力CT（HRCT） 　　AbstractObjectiveTo inquire into the HRCT features and clinical value of chronic otomastoiditis associated with impairment of the tympanic wall.MethodsThe image data on 28 cases (32ears) of chronic otomastoiditis was retrospectively analyzed.ResultsThe HRCT features of 28cases(32 ears) of chronic otomastoiditis associated with impairment of the tympanic wall were as the follows.(1)The roof of the tympanum was abnormal in 8 ears(25%),of which osteoporosis occurred in 2,the bone wall was thin in 1 and bone wall defects occurred in 5;(2)The carotid canal was abnormal in 6 ears (18.7%)，of which osteoporosis occurred in 2 and bone wall defects in 1;(3)The jugular foramen was abnormal in 5 ears (15.6%)，of which osteoporosis occurred in 2,the bone wall was thin in 1 and bone wall defects occurred in 2;(4)The sigmoid sinus wall was abnormal in 13 ears(40.6%),of which sigmoid groove defects occurred in 3,antrumtym panicum enlargement in 10 and dislocation of the auditory ossicles in 5;(5)The osseous labyrinthine wall was abnormal in 7 ears (21.8%),of which tympanum defects occurred in 1,the vestibular window was fuzzy in 1,fenestra cochleae defects occurred in 2,facial canal defects in 2 and lateral semicircular canal defects in 1;(6)The tympanic membrane was abnormal in 21 ears(65.6%),of which tympanic membrane defects occurred in 7,tympanic membrane thickening in 7,otopiesis in 5 and external auditory canal wall erosion in 2.ConclusionsAn axial and coronal view of HRCT is of clinica