山东大学耳鼻喉眼学报 ›› 2015, Vol. 29 ›› Issue (6): 1-4.doi: 10.6040/j.issn.1673-3770.0.2015.270

• 论著 •    下一篇

MSCT多模态三维重建观测颞骨结构及对人工耳蜗手术的指导意义

王一红1, 李瑞玉1, 陈彩龙2, 王晓燕1, 林美福2, 周硕2   

  1. 1. 福建医科大学省立临床医学院, 福建省立医院, 耳鼻咽喉科, 福建 福州 350001;
    2. 福建医科大学省立临床医学院, 福建省立医院, 核医学科, 福建 福州 350001
  • 收稿日期:2015-06-30 出版日期:2015-12-16 发布日期:2015-12-16
  • 作者简介:王一红. E-mail:entwyh@sina.com

Application of MSCT multimodal 3D reconstruction in the assessment of temporal bone structures and cochlear implantation

WANG Yihong1, LI Ruiyu1, CHEN Cailong2, WANG Xiaoyan1, LIN Meifu2, ZHOU Shuo2   

  1. 1. Department of Otolaryngology, Provincial Clinical Medical College of Fujian Medical University, Fuzhou 350001, Fujian, China;
    2. Department of Nuclear Medicine, Fujian Provincial Hospital, Provincial Clinical Medical College of Fujian Medical University, Fuzhou 350001, Fujian, China
  • Received:2015-06-30 Online:2015-12-16 Published:2015-12-16

摘要: 目的 探讨采用MSCT影像三维多模态重建技术在人工耳蜗植入术术前评估、术后复查中的应用价值.方法 ①应用双阈值重建技术显示耳蜗、前庭、半规管的膜性立体结构及听小骨,颞骨透明成像,逐一融合显示听小骨、内耳与颞骨的关系;②面神经曲面重建显示面神经的走行,观察面神经与面神经隐窝、外耳道后壁、鼓索神经等邻近结构的关系;③双斜径多平面重建(MPR)技术测量鼓岬平面面神经垂直段与鼓索神经的距离.结果 该组83例,内耳畸形11例中Mondini畸形2例、半规管畸形2例、共同腔畸形2例、内听道狭窄1例、前庭导水管扩大4例.正常结构耳鼓岬平面面神经垂直段与鼓索神经距离左侧(0.270±0.057)cm,右侧(0.280±0.068)cm.术后复查5例,清晰显示植入电极位置良好.结论 多模态重建技术能较好地满足临床多角度、全方位观察中耳和内耳解剖的需要,评估手术风险,确保手术顺利进行并可应用于术后复查植入电极的位置.

关键词: 三维多模态重建, 体层摄影术, X线计算机, 多层螺旋CT, 人工耳蜗植入, 颞骨, 面神经

Abstract: Objective To investigate the application and value of MSCT multimodal three-dimensional (3D) reconstruction in cochlear implantation. Methods ① The membranous structures with 3D imaging of cochlea, vestibular, semicircular canal and temporal bone transparent imaging were constructed with a double threshold reconstruction technique, where the anatomical relationship between ossicles, inner ear and temporal bone were displayed. ② The facial nerve reconstruction displayed the path of the facial nerve. The ultrastructure showed the facial nerve, facial nerve recess, posterior wall of the external auditory canal and the structure of chorda tympani nerve and neighboring structures. ③ The distance between promontory plane vertical segment of the facial nerve and chorda tympani nerve was measured. Results Of the 83 patients recruited in this study, 11 had inner ear malformation. Of them, 2 had Mondini malformation, 2 had semicircular canal malformation, 2 had common cavity malformation, 1 had internal auditory canal stenosis, and 4 had enlarged vestibular aqueduct. The distance between normal structure of cape plane vertical segment of the facial nerve and chorda tympani nerve was 0.27±0.057 cm at the left-side and 0.28±0.068 cm at the right-side. An intact structure of the implanted electrodes was clearly showed in 5 patients in the post-operative examination. Conclusion The 3D multimodal reconstruction technique is useful in providing ultrastructure imaging of the middle and inner ear, which is important for surgeons in pre-and post-operative evaluations of the success and potential risk factors for performing cochlear implantation.

Key words: Three dimensional reconstruction of multimode, Cochlear implantation, Tomography, Temporal bone, X-ray computed, Multi-slice spiral CT, Facial nerve

中图分类号: 

  • R764.1
[1] 张道行, 张岩昆, 田昊. 术前面隐窝气房CT测量对人工耳蜗植入术的意义[J]. 听力学及言语疾病杂志, 2006, 14(3):182-184. ZHANG Daoxing, ZHANG Yankun, TIAN Hao. Role of measuring facial recess in cochlear implantation[J]. J Audiol Speech Pathol, 2006, 14(3):182-184.
[2] Sennaroglu L, Saatci L. A new classification for cochleovestibular malformations[J]. Laryngoscope, 2002, 112(12):2230-2241.
[3] Mehl A L, Thomson V. The Colorado newborn hearing screening project, 1992—1999: on the threshold of effective population-based universal newborn hearing screening[J]. Pediatrics, 2002, 109(1):E7.
[4] 韩德民. 人工耳蜗[M]. 北京: 人民卫生出版社, 2003: 18-25.
[5] Jackler R K, Luxford W M, House W F. Congenital malformation of the inner ear: a classification based on embryogenesis [J]. Laryngoscope, 1987, 97(3):2-14.
[6] 李幼瑾, 杨军, 李蕴. 感音神经性聋患儿中先天性内耳畸形的构成、影像学及临床听力学特点[J]. 临床耳鼻咽喉头颈外科杂志, 2011, 25(1):1-5. LI Youjin, YANG Jun, LI Yun. Constitute imaging and auditory characteristics of pediatric patients with congenital malformations of inner ear in sensorineural hearing loss[J]. Clin J Otorhinolarynol Head Neck Surg, 2011, 25(1):1-5.
[7] Govaerts P J, Casselman J, Daemers K, et al. Cochlear implants in aplasia and hypoplasia of the cochleovestibular nerve[J]. Otol Neurotol, 2003, 24(6):887-891.
[8] 邱建新, 余德志. 影响人工耳蜗植入术效果的相关疾病[J]. 中国医学文摘耳鼻咽喉科学, 2011, 26(2):91-92. QIU Jianxin, YU Dezhi. Related diseases affecting the effect of cochlear implantation [J]. Otorhinolaryngol Chin Med Abs, 2011, 26(2):91-92.
[9] 刘寒波, 冯永, 陈登明, 等. CT 三维重建对人工耳蜗植入术后电极位置的观察[J]. 临床耳鼻咽喉科杂志, 2006, 20(13): 597-599. LIU Hanbo, FENG Yong, CHEN Dengming, et al. The application of 3D reconstruction of CT scans for the observation of the cochlear implanted electrode location[J]. J Clin Otorhinolaryngol, 2006, 20(13):597-599.
[10] Jain R, Mukherji S K. Cochlear implant failure: imaging evaluation of the electrode course of the electrode course[J]. Clin Radiol, 2003, 58(4):288-293.
[11] Xu J, Xu S A, Cohen L T, et al. Cochlear view:postsperative radiography for cochlear implantation[J]. Am J Otol, 2000, 21(1):49-56.
[12] 孔维佳, 马辉, 韩萍, 等. 人工耳蜗植入术后植入电极的影像学检查[J]. 中华耳鼻咽喉科杂志, 2004, 39(2): 81-84. KONG Weijia, MA Hui, HAN Ping, et al. Image examination of postoperative evaluation for the cochlear implanted electrode[J]. Chin J Otorhinolarynol, 2004, 39(2):81-84.
[13] Ozkei M, Kato Z, Sasai H, et al. Congenital inner ear malformations without sensorineural hearing loss in children[J]. Int J Pediatr Otorhinolaryngol, 2009, 73(10): 1484-1487.
[14] Mukerji S S, Parmar H A, Ibrahim M, et al. Congenital malformations of the temporal bone [J]. Neuroimag Clin N Am, 2011, 21(3):603-619.
[1] 李仕运,谢艳,潘佳煜,陈美馨,龙丹,张春林. 人工耳蜗植入对老年语后聋患者疗效的Meta分析[J]. 山东大学耳鼻喉眼学报, 2026, 40(3): 20-30.
[2] 高娟娟,许嘉,陈雯婧,梁思超,郭振平,陈俊言,郭翔,伊海金. 保留面神经功能的面神经鞘瘤次全切除手术治疗[J]. 山东大学耳鼻喉眼学报, 2025, 39(6): 8-16.
[3] 谢羡,陈义,刘斌,肖旭平,李湘胜. 颞骨过度气化并感染性休克1例并文献复习[J]. 山东大学耳鼻喉眼学报, 2025, 39(5): 108-113.
[4] 池文月,林垦,马静,杜玉玲,高映勤,周丽娟,张珩颖,张铁松. 不同语言环境及父母知信行对人工耳蜗植入术后患儿听觉言语康复的影响[J]. 山东大学耳鼻喉眼学报, 2025, 39(1): 8-15.
[5] 黄娇,彭昌福. 甲状腺相关性眼病活动性客观评价的研究进展[J]. 山东大学耳鼻喉眼学报, 2025, 39(1): 171-178.
[6] 索安奇,孙聚兴,牛红燕,周艳秋,牛鹏昊,毛文伟,李晓瑜,杨欣欣. 耳部钢筋复杂穿刺伤救治1例并文献复习[J]. 山东大学耳鼻喉眼学报, 2024, 38(2): 79-83.
[7] 冯琰琰,张丹旭,张康大,王林雨,王焕亮. 耳大神经阻滞对人工耳蜗植入术后患儿苏醒期谵妄的影响[J]. 山东大学耳鼻喉眼学报, 2023, 37(1): 15-19.
[8] 翟贯虹,于司函,张志强,于常旭,崔哲洙. 中耳胆脂瘤合并面瘫的手术后疗效分析[J]. 山东大学耳鼻喉眼学报, 2023, 37(1): 20-25.
[9] 温立婷,李旭,高伟,胡田勇,曾宪海,查定军. 17例中耳术后迟发性面瘫的临床特征分析[J]. 山东大学耳鼻喉眼学报, 2022, 36(5): 1-5.
[10] 韩书慧, 范新泰, 王娜, 王喆, 侯凌霄, 许安廷. 基于倾向得分匹配研究乳突气化程度与内淋巴囊发育的关系[J]. 山东大学耳鼻喉眼学报, 2022, 36(4): 22-26.
[11] 马宁, 陈敏, 刘薇, 杨扬, 邵剑波, 郝津生, 刘冰, 张晓, 段晓岷, 张祺丰, 张杰. 儿童颞骨骨折临床特点和治疗策略[J]. 山东大学耳鼻喉眼学报, 2022, 36(1): 13-19.
[12] 党攀红, 张睿, 胡春燕, 王洁, 樊孟耘. 儿童乳突-颞下迷路外面神经减压术8例临床分析[J]. 山东大学耳鼻喉眼学报, 2022, 36(1): 37-42.
[13] 万怡宁,张德军,傅则名,郭芳,郭颖媛,管国芳. 磁共振弥散加权成像在先天性中耳胆脂瘤精准诊断与JOS分期中的应用探讨12例[J]. 山东大学耳鼻喉眼学报, 2021, 35(6): 65-69.
[14] 秦贺,万宝刚,王洪丽,赵本绮. CT检查在真菌球型鼻窦炎术前诊断中的临床意义[J]. 山东大学耳鼻喉眼学报, 2021, 35(5): 32-35.
[15] 徐婧,瞿远珍,梁小芳,杨柳,汤洋. 视神经脊髓炎谱系疾病患者黄斑区及视盘周围视网膜血管参数变化特征[J]. 山东大学耳鼻喉眼学报, 2020, 34(4): 69-74.
Viewed
Full text


Abstract

Cited

  Shared   
  Discussed   
No Suggested Reading articles found!