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顳骨骨折之高解析度電腦斷層之評估
High-Resolution CT Evaluation of Temporal Bone Fracture
摘要
利用高解析度電腦斷層掃描儀(HRCT)來檢查顳骨(temporal bone)，其檢查時機為自剛開始受傷的幾天到5個月期間不等。在23位病人中共有25處骨折。在診斷顳骨骨折方面，每一位皆接受2 mm厚度axial切面的HRCT檢查，為了正確分析骨折的路徑，1mm coronal切面被利用於加強診斷能力並證實有幫助。HRCT檢查顯示出14個縱向，5個橫向，1個複雜性，1個非特異性，及兩個雙側性（2個縱向，1個複雜性，1個非特異性）的骨折。在23個病人中有21位產生顏面神經麻痺，在顏面神經管(facial canal)受傷的位置中，13位在膝體部(geun portion)，2位在岩骨部(petrous portion)，2位在鼓室部(tympanic portion)，2位在乳突部(mastoid portion)，另4位同時在膝體及鼓室部。23位病人中的13位有聽小骨的位移，包括6位砧鎚骨關節(incudomalleolar joint)，4位砧鐙骨關節(incudostapedial joint)脫位及3位聽小骨移離。HRCT亦顯示出13個鼓室積血，12個乳突積血，5個上鼓室積血，11個鄰近出血（硬腦膜下，蜘蛛膜下及顱內出血），及5位鄰近氣腦症。HRCT在評估不同型式的顳骨骨折及相關的合併症非常有效，它亦可提供手術矯正所需的重要資料。
並列摘要
High-resolution computed tomography (HRCT) of temporal bone was employed to examine 23 patients with 25 temporal bone fracture from a few days to 5 months after initial trauma The diagnosis of temporal bone fracture was obtained by 2 mm thickness axial HRCT in most cases; additional coronal HRCT with 1 mm slice thickness images showed to be helpful HRCT demonstrated 14 longitudinal,5 transverse, 1 complex, 1 atypical and 2 bilateral (2 longitudinal, 1 complex, 1 atypical) fractures. Twenty-one out of 23 patients had facial nerve palsy. The sites of facial canal injury included 13 in genu portion, 2 in petrous portion, 2 in tympanic portion, 2 in vertical portion and 4 in genu as well as some tympanic portions. Thirteen patients showed ossicular chain disintegrity, including 6 cases of incudomalleolar joint dislocation, 4 cases of incudostapedial joint dislocation and 3 cases of abnormal ossicle angulation apart. HRCT also demonstrated 13 hemotympanium, 12 hemomastoid, 5 hemoepitympanium, 11 local cranial hemorrhage (SDH, SAH, ICH), and 5 local pneumoencephalus. It is valuable for evaluation of different types of temporal bone fracture and associated complications and can also provided important information on surgical correction.