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目的:借助颞骨HRCT探讨单双侧先天性外中耳畸形患者外耳、乳突、鼓室及听小骨的畸形程度,以利于术前分析及进行术式的选择。方法:选取诊断为先天性外中耳畸形的患者29例35耳(研究组),以研究组中单侧耳畸形患者对侧健耳23例(23耳)作为对照组,全部患者行颞骨HRCT扫描,其中19例(19耳)行手术探查,分析患者外中耳及颞骨发育情况,统计学检验耳廓畸形与外耳道发育之间的关系,检验乳突气化程度与鼓室发育的关系;HRCT上行鼓室测量并进行对照分析。结合手术及HRCT表现,对听小骨常见锤砧骨畸形进行分类。结果:HRCT测量鼓岬至闭锁板的最短距离,对照组为(0.59±0.13)cm,单侧畸形组为(0.45±0.19)cm,双侧畸形组为(0.32±0.12)cm,单双侧畸形组分别与对照组比较,差异均有统计学意义。结合手术及HRCT检查,先天性外中耳畸形患者中听小骨正常1耳(2.86%),镫骨足板固定5耳(14.29%),无听骨3耳(8.57%),锤砧骨畸形26耳(74.29%)。锤骨与砧骨畸形常合并存在,畸形类型以锤骨退化、锤砧关节融合多见。结论:先天性外中耳畸形患者耳廓畸形程度与外耳道畸形程度相关;乳突气化不良者鼓室发育亦差。HRCT上单侧畸形组鼓岬至闭锁板的最短距离较对照组缩短0.15cm,双侧畸形组较对照组缩短0.25cm。本研究组听小骨畸形以锤砧骨畸形为主,其中以锤骨退化、锤砧关节融合多见。
Objective: To explore the degree of deformity of the external ear, mastoid, tympanic and ossicular bones in patients with unilateral and bilateral congenital external middle ear malformations by temporal bone HRCT in order to facilitate preoperative analysis and surgical choice. Methods: Twenty-nine patients (study group) with 29 cases diagnosed as congenital external middle ear malformations were selected. Twenty-three patients (23 ears) with unilateral ear deformity were selected as control group. All patients underwent temporal bone HRCT scan , 19 cases (19 ears) underwent surgical exploration to analyze the development of the external middle ear and temporal bone in patients. The relationship between the auricle deformity and the development of external auditory canal was statistically tested, and the relationship between the degree of mastoid gasification and tympanic development was examined. Tympanometry and control analysis. Combined with surgery and HRCT performance, common ankle malformations of ossicles were classified. Results: HRCT was the shortest distance between the promontory and the locking plate in the control group (0.59 ± 0.13) cm, (0.45 ± 0.19) cm in the unilateral deformity group and (0.32 ± 0.12) cm in the bilateral deformity group Deformity group were compared with the control group, the differences were statistically significant. Combined with surgery and HRCT, 1 case (2.86%) had normal auditory ossicles, 5 ears (14.29%) with stapes and 5 ears (8.57% 26 ears (74.29%). Malleus and incus deformity often co-exist, deformity type degeneration to the malleus, hammer anvil joint more common. Conclusion: The auricle deformity in patients with congenital external ear deformity is related to the degree of external auditory canal malformations. The mastoid dysplasia is also poor in tympanic development. HRCT unilateral deformity group promontory promontory to the locking plate shortest distance 0.15cm shorter than the control group, bilateral deformity group than the control group shortened 0.25cm. The study group to listen to the deformity of the main deformity of the hammer incarceration, which degenerated malleolus, hammer anvil joint more common.