本文選題：多層螺旋CT + 正常值��； 參考：《山西醫(yī)科大學(xué)》2011年碩士論文

【摘要】：目的：測(cè)量0-15歲正常兒童外耳、中耳、內(nèi)耳解剖數(shù)據(jù),探討我國(guó)兒童正常顳骨影像學(xué)特點(diǎn),為臨床、教學(xué)、科研提供幫助。 材料與方法：隨機(jī)選取山西省兒童醫(yī)院0-15歲無(wú)耳疾患的96例病例先行多層螺旋CT(multi-slice spiral computed tomography, MSCT)掃描檢查,獲得原始圖像后行多平面重組(multi-planar reformation, MPR)得到測(cè)量圖層,并在設(shè)定的層面上對(duì)顳骨各主要結(jié)構(gòu)的徑線進(jìn)行測(cè)量,記錄正常數(shù)值。再對(duì)各參數(shù)進(jìn)行年齡組間及性別組間的統(tǒng)計(jì)學(xué)分析。 結(jié)果：(1)外耳：外耳道峽部前后徑3.58±0.83mm。(2)中耳：鼓室上隱窩長(zhǎng)度4.18±1.13mm；鼓室上隱窩寬度3.47±0.82mmm；上鼓室前后徑6.90±1.02mm；上鼓室左右徑5.58±0.88mm；鼓竇入口寬度2.50±0.57mmm；鼓竇深度10.60±3.01mm；鼓室竇深徑3.19±0.80mm。(3)內(nèi)耳：耳蝸高度3.63±0.54mm；耳蝸基底轉(zhuǎn)長(zhǎng)度6.15±1.05mmm；耳蝸基底轉(zhuǎn)寬度1.27±0.28mm；前庭上下徑5.43±0.50mm；前庭左右徑2.86±0.35mm；外半規(guī)管骨島寬度3.93±0.52mm；上半規(guī)管骨島寬度6.10±0.63mmm；內(nèi)聽(tīng)道長(zhǎng)度為6.53±1.05mm；內(nèi)聽(tīng)道口徑5.76±1.64mm；內(nèi)聽(tīng)道寬徑4.31±0.83mm；蝸神經(jīng)孔橫徑2.12±0.51mm。(4)面神經(jīng)：面神經(jīng)迷路段長(zhǎng)度3.04±0.68mm；面神經(jīng)迷路段寬度0.88±0.38mm；面神經(jīng)鼓室段長(zhǎng)度9.40±3.15mm；面神經(jīng)鼓室段距砧骨短腳尖端最短距離2.41±0.79mm；面神經(jīng)乳突段到外耳道后壁距離為2.74±0.63mm；面神經(jīng)乳突段到外耳門(mén)后緣距離14.6±4.39mm：面神經(jīng)乳突段到乙狀竇溝前壁距離：11.18±1.55mmm。(5)乳突：乳突高度為22.49±9.18mm；測(cè)得乳突前后徑為18.96±5.44mm；乙狀竇距外耳道后壁距離12.94±1.71mm。(6)各年齡組測(cè)量數(shù)據(jù)無(wú)性別差異。鼓室上隱窩長(zhǎng)度、上鼓室左右徑、鼓竇入口寬度、耳蝸高度、前庭上下徑與左右徑、外半規(guī)管骨島寬度、上半規(guī)管骨島寬度、蝸神經(jīng)孔橫徑、面神經(jīng)鼓室段距砧骨短腳尖端最短距離、面神經(jīng)乳突段到乙狀竇溝前壁距離等指標(biāo)在各年齡組間無(wú)顯著性差異。外耳道峽部、鼓室竇深徑、耳蝸基底轉(zhuǎn)長(zhǎng)度及寬度、內(nèi)聽(tīng)道長(zhǎng)度、內(nèi)聽(tīng)道寬徑、面神經(jīng)乳突段到外耳道后壁或到外耳門(mén)后緣距離在1歲內(nèi)發(fā)育明顯；鼓室上隱窩出生后的發(fā)育是以寬度變化為主；上鼓室前后徑以5歲前發(fā)育明顯；鼓竇發(fā)育主要在出生后1-5歲；內(nèi)聽(tīng)道口徑、面神經(jīng)迷路段寬度、面神經(jīng)鼓室段長(zhǎng)度、乳突、乙狀竇到外耳道后壁距離出生后到15歲不斷發(fā)育中。 結(jié)論：(1)骨性外耳道的研究可從生后2月兒童開(kāi)始；骨性外耳道狹窄的診斷標(biāo)準(zhǔn)4mm并不適用于6歲以下兒童。(2)內(nèi)耳的結(jié)構(gòu)中耳蝸、前庭、半規(guī)管的骨性結(jié)構(gòu)不受年齡因素影響；(3)外耳、中耳大部分結(jié)構(gòu)以及內(nèi)聽(tīng)道的發(fā)育各有其年齡特點(diǎn),提示在臨床診斷及手術(shù)時(shí)應(yīng)充分考慮到年齡因素。
[Abstract]:Objective: to measure the anatomical data of external ear, middle ear and inner ear of normal children aged 0 to 15 years, and to explore the imaging features of normal temporal bone of children in China, so as to provide help for clinical, teaching and scientific research. Materials and methods: 96 patients aged 0-15 years without ear disease in Shanxi Children's Hospital were randomly selected to be examined by multi-slice spiral computed tomography, MSCT. After obtaining the original images, the multiplanar reconstruction multi-planar reformation (MPRR) was performed to obtain the measurement layer. The diameter of the main structures of the temporal bone was measured at the set level and the normal values were recorded. Then the parameters were analyzed between age groups and sex groups. Results: the outer ear: the anterior and posterior diameter of the isthmus of the external auditory meatus was 3.58 鹵0.83mm.f2) the middle ear: the length of the superior tympanic recess was 4.18 鹵1.13mm, the width of the superior tympanic recess was 3.47 鹵0.82mm, the anteroposterior diameter of the ependympanic chamber was 6.90 鹵1.02mm, the right and left diameters of the epigmpanic chamber were 5.58 鹵0.88mm, the width of the entrance to the tympanic sinus was 2.50 鹵0.57mm, the depth of the tympanic sinus was 10.60 鹵3.01mm; The depth diameter of tympanic sinus was 3.19 鹵0.80mm.Sp3) inner ear: cochlear height 3.63 鹵0.54mm; cochlear basal rotation length 6.15 鹵1.05mm; cochlear basal rotation width 1.27 鹵0.28mm; vestibular inferior diameter 5.43 鹵0.50mm; vestibular diameter 2.86 鹵0.35mm; width of outer semicircular canal bone island 3.93 鹵0.52mm; width of superior semicircular canal bone island 6.10 鹵0.63mm; length of inner auditory canal 6.53 鹵1.05mm; The length of the labyrinthine segment of the facial nerve was 3.04 鹵0.68 mm, the width of the labyrinthine segment of the facial nerve was 0.88 鹵0.38 mm, the length of the tympanic segment of the facial nerve was 9.40 鹵3.15 mm, the shortest distance from the tympanic segment of the facial nerve to the tip of the short foot of the incus was 2.41 鹵0.79 mm, the width of the inner auditory canal was 5.76 鹵1.64 mm, the width of the inner auditory canal was 4.31 鹵0.83 mm, the transverse diameter of the cochlear foramen was 2.12 鹵0.51 mm. The distance between the mastoid segment of the facial nerve and the posterior wall of the external auditory canal was 2.74 鹵0.63 mm, the distance between the mastoid segment of the facial nerve and the posterior margin of the external auditory canal was 14.6 鹵4.39 mm, and the distance between the mastoid segment of the facial nerve and the anterior wall of the sigmoid sinus sulcus was: the height of the mastoid process was 22.49 鹵9.18 mm, the diameter of the anterior and posterior mastoid process was 18.96 鹵5.44 mm. The distance between sigmoid sinus and posterior wall of external auditory canal was 12.94 鹵1.71 mm. Length of superior tympanic recess, left and right diameter of superior tympanic chamber, width of inlet of tympanic sinus, height of cochlea, superior and inferior diameter of vestibular vestibule, width of bone island of outer semicircular canal, width of bone island of superior semicircular canal, transverse diameter of foramen of cochlear nerve. There was no significant difference in the distance between the tympanic segment of the facial nerve and the tip of the short foot of the incus and the distance between the mastoid segment of the facial nerve and the anterior wall of the sigmoid sinus sulcus. The isthmus of the external auditory meatus, the deep diameter of the tympanic sinus, the length and width of the cochlear basal conversion, the length of the internal auditory canal, the width of the internal auditory canal, the distance from the mastoid segment of the facial nerve to the posterior wall of the external auditory canal or to the posterior margin of the external auditory canal developed significantly within 1 year of age. The width of the supratympanic recess was mainly changed after birth, the anterior and posterior diameter of the superior tympanic cavity was obviously developed before the age of 5 years, the development of the tympanic sinus was mainly between 1 and 5 years after birth, the caliber of the internal auditory canal, the width of the labyrinthine segment of the facial nerve, the length of the tympanic segment of the facial nerve, the mastoid process, The sigmoid sinus to the posterior wall of the external auditory canal continues to develop from birth to 15 years of age. Conclusion the study of osseous external auditory meatus can begin at 2 months after birth, the diagnostic criteria of osseous external auditory canal stenosis (4mm) is not applicable to children under 6 years of age) the middle cochlea, vestibule and semicircular canal are not affected by age factors. 3) most of the structures of the external and middle ears and the development of the internal auditory canal have their own age characteristics, which suggests that the age factors should be fully taken into account in the clinical diagnosis and operation.
【學(xué)位授予單位】：山西醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2011
【分類號(hào)】：R764

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