| BackgroundCongenital inner ear malformations, is the main factor causing nerve deafness in the clinic, serious influence patient’s quality of life. Electronic cochlear implant is the only effective treatment method for patients with congenital deafness at present implementation of hearing rehabilitation, in order to ensure the success of the operation, the clinician must grasp the operation characteristics of each patient, imaging data is objective and accurate reference. Three dimensional reconstruction of spiral CT has powerful functions, such as multiplanar reconstruction(MPR), especially of spiral CT in bone structure of good display ability, make the middle ear and inner ear structure can be completely displayed on the CT images, the fine structure can more clearly show.ObjectiveUsing spiral CT multiplanar reconstruction(MPR) technique, tympanic, mastoid antrum, malleus, incus, stapes and cochlea, vestibule, semicircular canal, round window, vestibular window structure observation of middle ear and inner ear, in the CT reconstruction images for the position, shape and size of the line, to provide morphological basis for clinical diagnosis of middle ear and the structures of the inner ear disease.Materials and methodsCollection of image Department Changyuan County People’s Hospital, during the period from 2012 January to 2013 December, the implementation of temporal bone scan of spiral CT images of 300 cases of the examination, no middle and inner ear malformation, inflammation, tumor, fracture, including 180 cases of male, female 120 cases, age August to 67 years old. Will be to check the original image data input CT 3D-reconstruction workstation using ADW 4.2 software, the reconstruction of multiplanar reconstruction (MPR) technique, bidirectional adjustment and reorganization of layer thickness and recombinant interval, in 1 or more than 1 plane rotation recombinant baseline, to show that the observed structure of whole or maximum degree shows its the whole. Using measuring software of 3D-reconstruction workstation, measured the anatomical structure of diameter line.Results1. In a two-way adjustment of middle ear multiplanar reconstruction(MPR) image reconstruction, can clearly display the anatomical structure of the malleus, incus mainly, incudomalleolar joint, stapes, incudostapedial joint, vestibular window. Left and right ear structure was symmetrical distribution, between the left, right and male, female showed no significant difference(P>0.05). Less than 6 years old age group and more than 6 attic between the age group of the upper and lower size and mastoid antrum horizontal diameter, anteroposterior diameter had significant difference(P<0.05), others such as auditory ossicles were not significant between the 2 age groups(P>0.05). The attic is less than 6 years of age. The vertical diameter and mastoid antrum horizontal diameter, anteroposterior diameter were(6.41±1.07) mm, (8.06±1.71) mm and (10.81±1.20) mm, attic is bigger than 6 years old age group of the upper and lower diameter and the diameter, before and after the left mastoid antrum diameters of (9.08±0.63) mm, (6.70±0.66) mm and (8.36±0.72) mm. Hammer head long, width and length of the malleus handle respectively (2.84±0.39) mm, (2.19±0.22) mm and (3.85±0.45) mm, the short and the long process of incus lengths (3.60±0.66) mm and (2.76±0.42) mm, front and rear foot length and stapes floor length were (2.57±0.38) mm, (2.60±0.44) mm and (2.68±0.37) mm. Before and after the epitympanic recess diameter, horizontal diameter were (9.70±0.74) mm and (6.31±0.48) mm, before and after the tympanum diameter, horizontal diameter, vertical diameter were (8.66±0.70) mm, (3.74±0.41) mm and (4.01±0.56) mm, before and after the hypotympanum diameter left and right superior inferior diameter, diameter, (7.65±0.66) mm, (2.81±0.35) mm and (2.99±0.34) mm respectively.2. In a two-way adjustment of the inner ear multiplanar reconstruction(MPR) image reconstruction, can clearly show the lateral semicircular canal, anterior semicircular canal, posterior semicircular canal, vestibular and cochlear and other major anatomical structure. The left and right inner ear structure was symmetrical distribution between the left and right side, men and women and less than 6 year old age group, more than 6 year old age group showed no significant difference(P>0.05). Perimeter before and after, lateral semicircular canal, vestibular window and the round window diameter were (13.02±1.68) mm, (13.59±1.60) mm, (13.05±1.23) mm and (2.08±0.55) mm, (2.70±0.49) mm, the height, length of cochlear and vestibular length diameter and width (3.50±0.52) mm, (6.21±1.04) mm and (5.75±0.50) mm, (2.90±0.67) mm respectively.Conclusion1. Bidirectional adjusting multiplanar reconstruction(MPR) can be achieved on the middle and inner ear anatomy shows structure of malleus, incus full, clear display, stapes, semicircular canal, vestibular and cochlear micro structure, and has important clinical significance in diagnosis.2. On the structure of the middle ear anatomy of tympanic and mastoid diameter anteroposterior diameter, horizontal diameter differences between age groups, have the characteristics of age, suggesting that in clinical diagnosis and operation should fully consider the age factor.3. The middle ear anatomy ossicles and the semicircular canals, vestibule and cochlear bone structure no age, gender, side and the difference between listening to the structure, the effect is not influenced by age, that the middle ear ossicles and the cochlea of the inner ear has reached adult levels at birth, to provide anatomical basis for the operation of artificial cochlea. |
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