外耳道CT测量参数在耳科手术中的临床应用价值OA

Objective To comparatively analyze computed tomography(CT)parameters of key anatomical regions within the external auditory canal(EAC),and provide a precise basis for preoperative planning of transcanal endoscopic surgical procedures.Methods Data of 43 patients(43 ears)diagnosed with chronic suppurative otitis media who underwent typeⅠtympanoplasty at Xijing Hospital of the Air Force Medical University between June 2020 and June 2023 were reviewed.The patients were divided into an intervention group and a control group based on whether circular canaloplasty was performed during the surgery.Age,gender,surgical side,perforation location and size,and imaging measurements were collected.The SPSS 26.0 software was used for statistical analysis.Receiver operating characteristic(ROC)curves were constructed for sensitivity and specificity of external auditory canal measurements on CT scans in reflecting external auditory canal stenosis.Results There were no significant differences between the two groups in gender,age,surgical side and size of perforation,but there were significant differences in the location of perforation(P<0.05).Differences between the two groups were seen in the anterior-posterior and superior-inferior diameters of the EAC isthmus,anterior-posterior diameter of the canal orifice,and the curvature angles of the anterior and inferior canal wall overhangs(P<0.05).Among them,the anterior-posterior(when≤4.5 mm)and superior-inferior(when≤7.0 mm)diameters of the isthmus showed high specificity in reflecting stenosis that might hinder visualization of the tympanic membrane and require canaloplasty.Additionally,a curvature angle of the inferior canal wall overhang≤136.7° could also influence the choice of surgical approach.Conclusions As the mandatory access route for transcanal endoscopic surgery,the external auditory canal has a direct impact on the surgical procedure.A detailed measurement of the anterior-posterior and superior-inferior diameters of the EAC isthmus and the curvature angle of the inferior wall on temporal bone CT is of significant value for meticulous preoperative evaluation.