Körner隔作为鼓室面神经-镫骨关系和上鼓室解剖的决定因素：基于CT的形态计量学分析和风险分层模型。
Körner's septum as a determinant of the tympanic facial nerve-stapes relationship and epitympanic anatomy: a CT-based morphometric analysis and risk stratification model.
文献信息
| PMID | 42763314 |
|---|---|
| 原文 | 在 PubMed 查看原文 ↗ |
| 发表日期 | 2026 |
| 作者 | Ömer Korkmazyürek |
| 作者单位 | Department of Otorhinolaryngology, Derik State Hospital, Mardin, Türkiye. |
| 期刊 | European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery |
| SCI 分区 | Q1 |
| IF | 2.3 |
| 研究类型 | 临床研究 · 临床 |
| 所属专科 | 耳科 |
中文摘要
目的： 定量评估Körner隔（KS）和齿突形态对鼓室面神经-镫骨关系和上鼓室空间构型的影响，重点关注面神经鼓室段（TFN）与镫骨足板之间的最小距离、前上鼓室隐窝（AER）体积以及相关的解剖变异。
方法： 共评估了249例患者的498块颞骨，包括116名女性（46.6%）和133名男性（53.4%），左右侧分布均等（右侧249块，左侧249块）。评估了TFN-镫骨距离（轴位、冠状位和最小距离）、AER体积、齿突长度以及TFN脱垂和开裂的存在情况。开发了一种新的手术通道约束指数（SCCI），用于对进入卵圆窗龛的手术难度进行分层。
结果： KS的存在与最小TFN-镫骨距离的显著减少相关（例如，在齿突不完整亚组中：0.90 ± 0.22 mm vs. 1.44 ± 0.44 mm，p < 0.001），并且AER体积显著减小（例如，在齿突完整亚组中：13.97 ± 5.70 mm³ vs. 24.61 ± 7.18 mm³，p < 0.001）。
结论： Körner隔是鼓室面神经-镫骨关系和上鼓室解剖的重要影像学决定因素，显著缩小TFN-镫骨距离，减少AER体积，并增加TFN脱垂的可能性。所提出的SCCI代表了一个初步的、产生假设的框架，用于描述卵圆窗区域的解剖约束，需要外部和术中验证。总体而言，这些发现强调了KS与术前解剖评估的潜在相关性，支持将基于影像的解剖评估整合到耳科手术中。
英文摘要
OBJECTIVE: To quantitatively evaluate the impact of Körner's septum (KS) and cog morphology on the tympanic facial nerve-stapes relationship and epitympanic spatial configuration, focusing on the minimum distance between the tympanic segment of the facial nerve (TFN) and the stapes footplate, anterior epitympanic recess (AER) volume, and associated anatomical variations.
METHODS: A total of 498 temporal bones were evaluated from 249 patients, including 116 women (46.6%) and 133 men (53.4%), with equal distribution between sides (249 right and 249 left). TFN-stapes distances (axial, coronal, and minimum), AER volume, cog length, and the presence of TFN prolapse and dehiscence were assessed. A novel Surgical Corridor Constraint Index (SCCI) was developed to stratify the surgical difficulty regarding access to the oval window niche.
RESULTS: The presence of KS was associated with a significant reduction in the minimum TFN-stapes distance (e.g., in the cog-incomplete subgroup: 0.90 ± 0.22 mm vs. 1.44 ± 0.44 mm, p < 0.001) and a marked decrease in AER volume (e.g., in the cog-complete subgroup: 13.97 ± 5.70 mm³ vs. 24.61 ± 7.18 mm³, p < 0.001).
CONCLUSION: Körner's septum is a significant radiological determinant of the tympanic facial nerve-stapes relationship and epitympanic anatomy, significantly narrowing the TFN-stapes distance, reducing AER volume, and increasing the likelihood of TFN prolapse. The proposed SCCI represents a preliminary, hypothesis-generating framework for describing anatomical constraints in the oval window region and requires external and intraoperative validation. Collectively, these findings highlight the potential relevance of KS to preoperative anatomical assessment, supporting the integration of imaging-based anatomical assessments in otologic surgery.