| PrefaceThe chronic otitis media with cholesteatoma was familiar disease in otology, which often caused to auditory ossicle erosion, deaf, serious one could caused the complication, such as subperiosteal abscess, endangered the sufferer seriously. After a patient was diagnosed as cholesteatoma, he needed the surgical operation treatment immediately. Auditory ossicle reconstructions played an important role in process in treatment to the conductive hearing losses. It was important for the doctor to understand the location, appearance, damaged degree of auditory ossicle and to guide the treatment and judge the future.ObjectiveTo analyse the auditory ossicle changes images of axial and the MPR coronal reconstruction of MSCT in chronic otitis media with cholesteatoma, which were checked against with surgical operation, and to inquire into the MSCT performance and its application value.Material and methodExperiment object; Thirteen patients (9 man, 4 woman; age range, 9-52; mean age, 34years) with chronic otitis media with cholesteatoma underwent MSCT before surgery, during February of 2003 to December of 2003, totally 14 examples (n = 14) , surgical operation of department of Otorhinolaryngology, the Second Affiliated Hospital of CMU with pathology proof . Three of them was also with inflammation.Experiment equipments and methodEquipments; Marconi 8000 (4 row) scanner.Method: The sufferer lied on the back, sweeping first to position an empress, and setting up the plan. Scaned the scope from external ear bore to the upper edge of petrous bone.Parameter: layer thick; 0.6 mm -1.3mm, pitch; 0.875 mms, reconstruction partition 0.3 mm-0. 6mm, window breadth; 3000 Hu, window level; 200-400 Hu, matrix; 1024 1024 with a 8. ocm field of view. All cases were adopted the axial scan, then a coronal reconstruction. The appearance of auditory ossicle of MSCT was divided into disappearance ( all or part) , destruction (include auditory ossicle density was lower, the edge was not smooth) , displacement , joint fixation according to the way and degree. The auditory ossicle changes to malleus head, malleus handle, incus long process, incus short process, stapes, malleus head and malleus handle, incus long process and incus short process, malleus, incus and stapes, pure joint were counted respectively in the axial and coronal section. All the bone changes were wrote down compared with the normcl side, besides a patient suffered from both side, the others were normal through examinations and MSCT . The results were checked against with the conduct and actions that surgical operation were thought as gold standard. Ossic-ular chain changes founded in the surgical operation were also to be recorded after surgical operation.After that, the statistic methods were used to evaluate the results.ResultOssicular chain changes could be seen as follows; Six malleus head were founded to disappear in the axial, five malleus head disappeared in the coronal, but the disappearance of six malleus head were found during the surgical operation. There were four malleus head which destructed in the axial; five malleus head destructed in the coronal, but the destruction of five malleus head were found during the surgical operation. One malleus head displacement was watched in the axial, coronal, surgical operation respectively. There were sixmalleus handle which disappeared in the axial, four malleus handle disappeared in the coronal, but the disappearance of five malleus handle were found during the surgical operation. There were five malleus handle which destructed in the axial, four malleus handle destructed in the coronal, but the destruction of five malleus handle were found during the surgical operation. One malleus handle displacement was watched in the axial, coronal, surgical operation respectively. There were five long process of incus which disappeared in the axial, six long process of incus disappeared in the coronal, but the disappearance of six long process of incus were found during the surgical operation.
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