摘要目的 通过研究先天性外耳道狭窄、先天性外耳道闭锁患者圆窗龛及其附近龛外窝形态的差异,获得圆窗龛及龛外窝形态的参数,为人工中耳圆窗振子的外形设计及其在圆窗龛植入时的安全放置提供依据.方法 将17例(20侧耳)先天性外耳道狭窄患者(狭窄组,男9例、女8例,年龄7～28岁)、15例(20侧耳)先天性外耳道闭锁患者(闭锁组,男9例、女6例,年龄4～27岁)和10例健康人(健康对照组,20侧耳,男5例、女5例,年龄12 ～60岁)的颞骨CT序列图像导入Mimics软件,在3D重建基础上读取圆窗龛及其附近龛外窝相关标志点的三维坐标,基于Matlab软件编制程序计算圆窗龛龛口前后、上下径,圆窗前后、内外径,圆窗龛前、后、上、下各壁长度,圆窗龛深度,龛外窝深度及大小,对数据进行统计分析.结果 闭锁组圆窗龛前、后壁长度分别为(1.48 ±0.26) mm和(2.28±0.56) mm,狭窄组分别为(1.32 ±0.36)mm和(1.99±0.58)mm,健康对照组分别为(0.96 ±0.33)mm和(1.55±0.53)mm,差异均有统计学意义(P值均＜0.05);闭锁组圆窗龛上壁长度(1.29 ±0.32) mm,大于健康对照组的(1.00 ±0.33) mm(P ＜0.05);闭锁组的龛外窝大小小于狭窄组,狭窄组小于健康对照组,差异均有统计学意义(P值均＜0.05).龛外窝深度在3组间比较差异均无统计学意义(P值均＞0.05).结论 随着外耳道畸形程度加重,圆窗龛前、后、上壁有变长趋势,龛外窝有变小的趋势.该结果可为人工中耳圆窗振子的设计及先天性外耳道狭窄和闭锁患者圆窗振子植入的手术设计提供依据.

abstractsObjective To investigate the morphological difference of round window niche and outside fossa among the congenital aural atresia,the external auditory canal stenosis and the normal controls in order to obtain the reference value and provide the basis for the design and safe implantation of the transducer in the area of round window niche.Methods CT serial images of 20 ears of 10 health subjects including 5 males and 5 females aged 12 to 60 years,20 ears of 17 external auditory canal stenosis subjects including 9 males and 8 females aged 7 to 28 years,and 20 ears of 15 congenital aural atresia subjects including 9 males and 6 females aged 4 to 27 years were imported into Mimics software for image processing.Three-dimensional coordinate values of landmarks of the round window niche and outside fossa were acquired.Then,anteroposterior diameter and suprainferior diameter of the round window niche opening,anteroposterior diameter and medial-lateral diameter of the round window,anterior wall,posterior wall,superior wall,inferior wall of the round window niche,the depth of round window niche and outside fossa,and the size of outside fossa were calculated by Matlab software.Finally,the data were analyzed statistically.Results The length of the anterior and posterior walls of the round window niche of atresia group [(1.48 ± 0.26) mm,(2.28 ± 0.56) mm] were found to be greater than those of stenosis group [(1.32 ± 0.36) mm,(1.99 ± 0.58) mm] (P ＜0.05),and their values of stenosis group were greater than those of health group [(0.96 ± 0.33) mm,(1.55 ±0.53) mm] (all P values ＜ 0.05).The length of superior wall of the round window niche of atresia group (1.29 ± 0.32) mm was greater than that of health group [(1.00 ± 0.33) mm] (P ＜ 0.05).The size of outside fossa of atresia group was smaller than stenosis group(P ＜0.05),and the size of stenosis group was smaller than that of health group (all P values ＜ 0.05).There was no statistical significant difference of the outside fossa depth among different groups (all P values ＞ 0.05).Conclusions With the aggravation of the external auditory canal malformation,anterior wall,posterior wall,as well as superior wall of the round window niche got longer and the size of outside fossa will get smaller,this paper provides novel information for the better design,selecting and safer implantation of the transducer in the area of round window niche.