摘要
目的应用64排螺旋CT对听神经瘤内听道及周围结构进行研究,为临床提供重要信息,为决定手术方式提供依据。方法 30例听神经瘤患者术前行颅底CT薄层扫描观察其患侧内听道形态、内听道周围乳突气房及颈静脉球等情况。结果听神经瘤患侧内听道表现为三种形态:喇叭口状22例(73.3.0%),壶腹状6例(20.0%),不规则形2例(6.7%)。其中1例不规则形及3例喇叭口状因内听道口较大未行磨开内听道后壁,通过直接牵拉切除内听道肿瘤。19例喇叭口状、6例壶腹状及1例不规则形行磨开内听道后壁切除内听道肿瘤。其中3例术前CT提示合并有颈静脉球高位,术中在磨除内听道后壁时尽量靠近内听道上嵴,且磨除长度较少,以防止颈静脉球破裂出血。另有2例术前CT显示乳突气化良好,乳突气房临近内听道后壁,术中在磨除内听道后壁时乳突气房被磨开,并立即进行封闭,术后出现轻微脑脊液漏。结论听神经瘤应常规行颅底CT薄层扫描进行术前评估,有助于临床决定是否磨开内听道后壁及磨除范围,提高手术全切除可能,降低对患者的创伤。
Objective 64-slice spiral CT was applied to research internal auditory canal and the surrounding structures. To provide important information for preoperative evaluation of acoustic neuroma and to predjct the operative pmcedures.Methods 30 cases with acoustic neuroma underwent the thin CT scanning of the skull base. To observe the form of internal auditory canal, mastoid air cells and jugular bulbin in acoustic neuroma.Results Internal auditory canal of acoustic neuroma were divided into three forms：trumpet（n：22, 73.3.0%）, ampulla（n=6, 20.0%）and irregular（n=2, 6.7%）. Due to the large internal auditory canal,the posterior wall of internal auditory canal were not removed and the tumor were directly removed through the drawing in 1 case of irregular and 3 cases of ampulla. The posterior walls of internal auditory canal were removed in 19 cases of trumpet, 6 cases of ampulla and 1 case of irregular.3 cases complicated with high jugular bulb. High speed steel cutting drill was used to drill the posterior walls of internal auditory canal as close as possible to the inner rear wall and as shorter as possible ,to prevent jugular bulb bleeding. 2 cases showed good gasification mastoid. Mastoid air cells were opened during the surgery and were closed immediately, having slight leakage of cerebrospinal fluid after surgery.Conclusion Thin CT scanning of the skull base should be done routinely for preoperative assessment of acoustic neuroma. Because it is helpful to the appropriate management of the posterior wall of internal auditory canal.All of these can improve surgical resection and reduce the trauma to the patient.
出处
《中国CT和MRI杂志》
2016年第8期84-85,89,共3页
Chinese Journal of CT and MRI
关键词
内听道
听神经瘤
体层摄影术
X线计算机
Internal Auditory Canal
Acoustic Neuroma
Tomography
X-ray Computed
