【摘要】 目的初步探讨CT三维重建对耳内镜下鼓峡手术的参考价值,为耳内镜手术的术前评估提供帮助。方法选取固定的成人头颅标本6具(12侧),运用CT三维重建技术,制作鼓峡的3D模型进行观察和测量,与耳内镜解剖的观察和测量结果进行比较。选取病例2例,制作术侧耳的3D模型进行观察,与耳内镜术中所见情况进行比较。结果用标本CT原始数据制作的鼓峡的3D模型上可观察到鼓前峡、鼓后峡、听骨链、匙突、面神经、鼓岬和咽鼓管鼓室口等结构,不同视角下,3D模型上各个解剖结构的形态及位置关系均与耳内镜解剖所见相近,3D模型测量与解剖测量数据间差异均无统计学意义(P>0.05)。用病例CT原始数据制作的3D模型上还可观察到病变的大致形态及其位置,观察结果与耳内镜术中所见情况相符。结论 CT三维重建能充分利用CT原始数据,术前即能实现直观、立体、多角度的观察,其在成像方面诸多特点与耳内镜相似,对耳内镜下鼓峡手术具有一定参考价值。更多还原

【Abstract】 Objective To investigate the clinical value of CT three-dimensional reconstruction in surgery of tympanic isthmus under endoscope,and to provide preoperative evaluation for endoscopic ear surgery. Methods CT scan was performed on 6 fixed skull specimens(12 ears),and the 3D models of tympanic isthmus were derived from three-dimensional reconstruction. Tympanic isthmus were observed and measured on the 3D models and the dissected skull specimens for comparison. Two typical cases were selected. The 3D models of the affected ears were derived from three-dimensional reconstruction and observed, the affected ear were also observed during endoscopic ear surgery, then the findings were compared as well.Results The structures observed on the 3D models of tympanic isthmus included anterior isthmus,posterior isthmus,the whole ossicluar chain, cochlearform process, facial nerve, promontory, eustachian tube,etc. The morphology and positional relationship of each anatomical structure on the 3D models were similar to those observed under the endoscopic dissection.No statistically significant differences were found between the data derived from CT measurement and from anatomical measurement(P>0.05). The 3D models could also show the morphology and location of lesions in the affected ears of the selected cases,which was consistent with the observation under endoscope.Conclusion CT three-dimensional reconstruction can make full use of the original CT data and present visual,stereoscopic and multi-angle observation as endoscope does before operation,which has reference value for endoscopic surgery of tympanic isthmus.更多还原