| Objective:High resolution computer tomography(HRCT)of the temporal bone and Multiplanar reconstruction(MPR)technology was used to measure the width of the Facial Nerve Recess(FNR)and the distance of the surrounding anatomical structures in the Inner ear malformation(IEM)to understand the anatomical development of FNR in patients with IEM.The difficulty and maximum resectable range of Cochlear implantation(CI)for IEM patients were evaluated,and the Facial nerve(FN)was protected,thus providing data support and reference range for clinical CI.Methods:A total of 68 temporal bone HRCT patients(136 ears)with unilateral CI in the Affiliated Hospital of Yan ’an University from April 2015 to February 2021 were collected.According to currently accepted 2010 clinical Sennaroglu IEM classification method,such as analysis of the inner ear and classification,ear deformity or normal ears of 66 cases(132 ears),two patients(4 ears)with one ear malformation and the other normal ear were classified into the IEM group,i.e.,36 patients(70 ears)in the IEM group were used as the experimental group,and 32 patients(66 ears)in the normal inner ear group were used as the control group;In the IEM group,there were 34 cases of binaural malformation(68 ears)and 2 cases of monaural malformation(2 ears).In the IEM group,there were 29 male ears,41 female ears,34 right ears and 36 left ears,aged from 1 to 18 years old,6.00(3.00 to 11.00)years old.Then,the temporal bone HRCT MPR technique was used to measure the width of FNR and surrounding anatomy of data at the level of Round window niche(RWN): 1.The width of FNR;2.The height of mentia pyramidalis;3.The distance from the inner edge of Vertical facial nerve(VFN)to RWN;4.The distance between the lateral edge of the VFN and the lateral wall of the mastoid process;5.The distance between the short foot of the incus and the second knee of the facial nerve(i.e.the turning point between the horizontal segment of the facial nerve and the VFN);6.Distance of stapes head to RWN.The IEM groups related to the width of the inner ear FNR normal group and the surrounding anatomical point measurement data if there is a difference,the width of the IEM group FNR and the surrounding of the anatomy of the related points measuring around men and women,and whether there are different;the IEM group is divided into three groups according to age(the first set of 1-4 years,the second group of 5 to 10 years old,and the third group were11 years old-18 years of age),and explore the width of the IEM group FNR and its surrounding anatomical structures whether development varies with age.Results:1 In the normal group,the width of FNR was(4.17±0.39)mm,the height of mentia pyramidalis was(1.92±0.22)mm,the distance from the medial margin of VFN to RWN was(5.25±0.31)mm,the distance from the lateral margin of VFN to the lateral wall of the mastoid process was(17.46±3.27)mm,the distance from the short foot of incus to the second knee of facial nerve was(3.09±0.32)mm,and the distance from the head of stapes to RWN was(2.05±0.21)mm.In the IEM group,the width of FNR was(4.15±0.22)mm,the height of mentia pyramidalis was(1.98±0.19)mm,the distance from the medial margin of VFN to RWN was(5.33±0.33)mm,the distance from the lateral margin of VFN to the lateral wall of the master process was(16.99±3.50)mm,the distance from the short foot of the incus to the second knee of the facial nerve was(3.11±0.20)mm,and the distance from the head of stapes to RWN was(2.11±0.36)mm.There was no significant difference between the two groups in the range measurement at each anatomical point(P > 0.05).2 In the male group of IEM group,the width of FNR was(4.17±0.24)mm,the height of mentia pyramidalis was(1.93±0.18)mm,the distance from the medial margin of VFN to RWN was(5.38±0.30)mm,the distance from the lateral margin of VFN to the lateral wall of the papillary process was(16.81±370)mm,the distance from the short foot of the incus to the second knee of the facial nerve was(3.12±0.20)mm,and the distance from the head of stapes to RWN was(2.12±0.40)mm.In the female group,the width of FNR was(4.14±0.20)mm,the height of mentia pyramidalis was(2.01±0.16)mm,the distance from the medial margin of VFN to RWN was(5.28±0.35)mm,the distance from the lateral margin of VFN to the lateral wall of the mastoid process was(17.15±3.36)mm,the distance from the short foot of incus to the second knee of facial nerve was(3.09±0.20)mm,and the distance from the head of stapes to RWN was(2.10±0.33)mm.There was no significant difference in the range values of each anatomical point between male and female groups(P > 0.05).3 In the IEM group,the width of FNR in the right ear group was(4.16±0.23)mm,the height of mentia pyramidalis was(1.99±0.19)mm,the distance from the medial margin of VFN to RWN was(5.33±0.33)mm,the distance from the lateral margin of VFN to the lateral wall of the papillary process was(16.71±3.54)mm,the distance from the short foot of the incus to the second knee of the facial nerve was(3.13±0.16)mm,and the distance from the stapes head to RWN was(2.13±0.38)mm.In the left ear group,the width of VFN was(4.14±0.23)mm,the height of mentia pyramidalis was(1.97±0.19)mm,The distance from the medial margin of VFN to RWN was(5.33±0.34)mm,the distance from the lateral margin of VFN to the lateral wall of the mastoid process was(17.25±3.50)mm,the distance from the short foot of incus to the second knee of the facial nerve was(3.08±0.23)mm,and the distance from the head of stapes to RWN was(2.10±0.36)mm.There was no significant difference between the two groups(P>0 0.05)in the range measurement at each anatomical point.4 There were no significant differences in the width of FNR,height of mentia pyramidalis,distance from the medial margin of VFN to RWN,and distance from the short foot of incus to the second knee of facial nerve between the three IEM groups(P >0.05).The distance between the lateral margin of VFN and the lateral wall of the mastoid process was significantly different among the three age groups(P < 0.05).After further pairwise comparison,it was found that the distance between the lateral margin of VFN and the lateral wall of the mastoid process was significantly different between the two groups.Conclusion:1 There was no significant difference in the width of FNR and the relevant anatomical distance between the IEM group and the normal inner ear group.2 There were no significant differences in the width of FNR and its surrounding anatomical distance in gender,left and right groups of patients in the IEM group.3 The distance from the lateral margin of VFN to the lateral wall of the mastoid process in IEM group changed with age.However,the width of FNR and the distance of other anatomical structures around it were fully developed from birth and did not change with age. |
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