Width of the Extended Facial Recess: A Numerical Study of Ultrahigh-Resolution Computed Tomography and Its Implications in Minimally Invasive Otologic Surgery
Width of the Extended Facial Recess: A Numerical Study of Ultrahigh-Resolution Computed Tomography and Its Implications in Minimally Invasive Otologic Surgery
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扩大面部凹陷的宽度：超高分辨率计算机断层扫描的数值研究及其在微创耳科手术中的意义
DOI：
10.1097/01.mao.0000178141.04601.dc
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发表时间：
2005
影响因子：
2.1
通讯作者：
M. Luntz
中科院分区：
文献类型：
--
作者：
C. Teszler;D. Ruimi;E. Bar;M. Luntz
背景：微创计算机辅助耳科手术方法落后于其他领域。原因似乎是颞骨重要结构之间的通道尺寸极小，而且这些结构被包裹在骨框架中，在钻孔之前被遮盖，并且不可移动。延长的面部隐窝是通向鼓室的手术通道。它的内侧以面神经为界，外侧以鼓室环为界，并且因个体而异。对于计算机辅助微创颞骨手术，高分辨率清晰度至关重要。目的：确定延长的面部凹陷的宽度并评估计算机化的结果，作为耳科手术计划的术前和术中辅助。方法：对 100 名男性和 100 名女性患者的双侧颞骨高分辨率计算机断层扫描图像在五个水平（尾侧到头侧）进行两次测量，首先使用与窗口无关的算法（扩展面部隐窝，半最大全宽），在计算机断层扫描图像处理工作站中实施，然后在相同的轴向计算机断层扫描图像上手动使用卡尺。结果：正如预期的那样，扩展面部隐窝半高全宽方法获得了最宽的值（女性患者为 4.15 ± 0.41 毫米，男性患者为 4.32 ± 0.54 毫米）。从该水平向下，扩展面部隐窝半高全宽方法在最内部水平处逐渐减小至女性患者的 2.50 ± 0.56 毫米和男性患者的 2.42 ± 0.46 毫米。手动方法（扩大面部隐窝、计算机断层扫描图像）在所有级别上产生的值明显高于使用客观的、与窗口无关的方法获得的值，并且在某些级别上高出多达三分之一。在 2 级（大致相当于圆窗），女性研究组的面部凹陷延伸为 4.00 ± 0.65 毫米，男性研究组的面部凹陷延伸为 4.11 ± 0.67 毫米。结论：诸如扩展面隐窝、半高全宽法等图像处理方法可能会导致微调，从而改善计算机辅助耳科手术。在临床应用并在耳科手术中完全依赖这些自动化方法之前，应进一步验证其可靠性。
Background: Methods of minimally invasive computer-assisted otologic surgery lag behind other fields. The reason seems to be the extremely small dimensions of the corridors between important structures in the temporal bone and the fact that these structures are encased in bony frameworks, are obscured before drilling, and are not movable. The extended facial recess is a surgical pass to the tympanic cavity. It is bounded medially by the facial nerve and laterally by the tympanic annulus, and varies among individuals. For computer-assisted, minimally invasive temporal bone surgery, high-resolution definition is critically important. Aims: To determine the width of the extended facial recess and evaluate the computerized findings as a pre- and intraoperative aid to otologic surgery planning. Methods: Bilateral temporal bone high-resolution computed tomographic images of 100 male and 100 female patients were measured twice at five levels (caudal to cephalic), first using a window-independent algorithm (extended facial recess, full-width at half-maximum), implemented in a computed tomographic image-processing workstation, and then manually with calipers on the same axial computed tomographic images. Results: As expected, the extended facial recess, full-width at half-maximum method yielded the widest values superiorly (4.15 ± 0.41 mm in the female patients and 4.32 ± 0.54 mm in the male patients). From this level down, the extended facial recess, full-width at half-maximum method yielded values that tapered gradually to 2.50 ± 0.56 mm in the female patients and 2.42 ± 0.46 mm in the male patients at the most interior level. The manual method (extended facial recess, computed tomographic images) yielded a significantly higher value than that obtained with the objective, window-independent method at all levels, and at some levels was higher by as much as one-third. At Level 2, which corresponded roughly to the round window, the extended facial recess was 4.00 ± 0.65 in the female study group and 4.11 ± 0.67 mm in the male study group. Conclusion: Image processing methods such as extended facial recess, full-width at half-maximum method might lead to fine tuning and thus improvement of computer-assisted otologic surgery. Before clinical application and complete dependence on these automated methods during otologic surgery, their reliability should be further validated.
DOI：
10.3109/00016489309128539
发表时间：
1993
期刊：
Acta oto-laryngologica. Supplementum
影响因子：
--
作者：
M. Dahm;R. Shepherd;G. Clark
通讯作者：
M. Dahm;R. Shepherd;G. Clark