RESUMO
BACKGROUND: Segmentation of important structures in temporal bone CT is the basis of image-guided otologic surgery. Manual segmentation of temporal bone CT is time- consuming and laborious. We assessed the feasibility and generalization ability of a proposed deep learning model for automated segmentation of critical structures in temporal bone CT scans. METHODS: Thirty-nine temporal bone CT volumes including 58 ears were divided into normal (n = 20) and abnormal groups (n = 38). Ossicular chain disruption (n = 10), facial nerve covering vestibular window (n = 10), and Mondini dysplasia (n = 18) were included in abnormal group. All facial nerves, auditory ossicles, and labyrinths of the normal group were manually segmented. For the abnormal group, aberrant structures were manually segmented. Temporal bone CT data were imported into the network in unmarked form. The Dice coefficient (DC) and average symmetric surface distance (ASSD) were used to evaluate the accuracy of automatic segmentation. RESULTS: In the normal group, the mean values of DC and ASSD were respectively 0.703, and 0.250 mm for the facial nerve; 0.910, and 0.081 mm for the labyrinth; and 0.855, and 0.107 mm for the ossicles. In the abnormal group, the mean values of DC and ASSD were respectively 0.506, and 1.049 mm for the malformed facial nerve; 0.775, and 0.298 mm for the deformed labyrinth; and 0.698, and 1.385 mm for the aberrant ossicles. CONCLUSIONS: The proposed model has good generalization ability, which highlights the promise of this approach for otologist education, disease diagnosis, and preoperative planning for image-guided otology surgery.
Assuntos
Redes Neurais de Computação , Cirurgia Assistida por Computador , Osso Temporal/diagnóstico por imagem , Tomografia Computadorizada por Raios X , Conjuntos de Dados como Assunto , Humanos , Processamento de Imagem Assistida por Computador , Osso Temporal/patologia , Osso Temporal/cirurgiaRESUMO
Objective:To assess and compare therapeutic effects and quality of life after endoscopic and microscopic myringoplasty using Chinese version of the Zurich chronic middle ear inventoryï¼ZCMEIï¼. Methods:Patients with chronic suppurative otitis media underwent myringoplasty at the Third Hospital of Peking University from October 2018 to September 2019 were included in this study and divided into two groups: endoscopic tympanoplasty groupï¼n=40ï¼ and microscopic tympanoplasty groupï¼n=57ï¼. ZCMEI survey and pure tone audiometry were conducted preoperatively and 3-9 months postoperatively. The operation time, intraoperative blood loss, length of hospital, graft success rate, complication rate, hearing improvement and quality of life improvement were compared. Results:â The operation time, length of hospital and intraoperative blood loss of endoscopic group were significantly lowerï¼P<0.05ï¼. â¡The graft success rate was 92.5% and 98.2%, respectivelyï¼P>0.05ï¼. The difference between the complication rate in two groups was not significant, but patients in endoscopic group had no symptoms of wound numbness or pain. â¢Air conduction thresholdï¼ACï¼ and air-bone gapï¼ABGï¼ were significantly lower after surgery in endoscopic groupï¼n=33ï¼ and microscopic groupï¼n=43ï¼. The analyzed result of generalized linear model indicated surgical approach had no influence on postoperative AC and ABGï¼P>0.05ï¼. â£The total scores of ZCMEI were significantly improved in endoscopic groupï¼n=32ï¼ and microscopic groupï¼n=48ï¼ postoperatively, as well as the scores of ear symptoms, hearing and psychosocial impactï¼P<0.05ï¼. Preoperative and postoperative scores of medical resources were not significantly different in either groupsï¼P>0.05ï¼. Controlling the course of disease, the total ZCMEI results and scores of each subscale in patients with single ear involvedï¼n=71ï¼ had no significant difference between two groups. Conclusion:Endoscopic myringoplasty has the advantages of minimal invasiveness, short operation time, and quick recovery evaluated from subjective and objective aspects. Audiometry improvement, graft success rate, complication rate and quality of life improvements are comparable between endoscopic tympanoplasty and conventional microscopic tympanoplasty. The assessment of the quality of life is of great significance in efficacy evaluation of otitis media. Doctors should comprehensively consider patient's subjective experience and the objective improvement to obtain the best clinical efficacy.
Assuntos
Miringoplastia , Qualidade de Vida , China , Doença Crônica , Orelha Média , Humanos , Estudos Retrospectivos , Resultado do Tratamento , TimpanoplastiaRESUMO
Persistent rhinitis (PR) is a chronic disease that affects millions of people. However, it lacks of a useful method, which can indicate the actual severity of the inflammation in PR patients. This study was designed to seek an examination which could reflect the actual severity of PR disease. The serum Phadiatop test, ECP level, four-phase rhinomanometry, and acoustic rhinometry were assessed in 91 adult patients with PR and 10 healthy controls. The serum total IgE was determined in some of the patients and all of the controls. The patients were divided into four groups: ARWO, ARWTO, NARWO and NARWTO. 40% (22/55) of AR and 33.3% (13/36) of NAR patients never complained of persistent nasal obstruction. Serum ECP levels were increased in the ARWO group. Serum total IgE was significantly elevated in the AR groups. MCA(1-Min) and MCA(1-T) were significantly reduced in the ARWO, ARWTO, and NARWO groups. NV(6-Min) and NV(6-T) were decreased in all PR groups, but only some of these differences were significant. In the ARWO group, MCA(2-Min) (r = -0.252), MCA(2-T) (r = -0.377), NV(6-Min) (r = -0.32), and NV(6-T) (r = -0.311) had significant relationships with serum ECP. We recommend acoustic rhinometry as a useful routine tool for the diagnosis of PR, even among patients without persistent subjective nasal obstruction. This technique might reveal the actual status of nasal congestion. An elevated serum ECP level might indicate severe AR and is negatively correlated with the results of acoustic rhinometry.