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目的:联合咽鼓管声测法(Sonotubometry,STM)和螺旋CT观察健康人咽鼓管开放状态下的功能和形态,通过STM训练咽鼓管开放动作并优化CT参数,以期对咽鼓管做出更全面的评估。方法:13名健康志愿者(男10名,女3名,年龄22~26岁)经STM监测下的咽鼓管主被动开放训练后,在立位和仰卧位下测得吞咽、捏鼻鼓气(Valsalva动作)时的咽鼓管开放持续时间和声压最大值。CT设置参数A(扫描层厚6.0 mm,层厚手动重建为0.6 mm,三维重建层厚0.6 mm)和参数B(扫描层厚0.4 mm,三维重建层厚0.4 mm);在参数A下行静态扫描和Valsalva扫描,在参数B下行Valsalva扫描。多平面重建后测量咽鼓管骨部和软骨部的面积。采用SPSS 19.0软件进行统计学分析。结果:两种体位下,Valsalva动作较吞咽动作的咽鼓管开放持续时间更长,开放声压最大值更大,差异有统计学意义(n P值均<0.05)。立位比仰卧位Valsalva动作咽鼓管开放持续时间更长(n P<0.05)。在CT参数A条件下,Valsalva动作下测量的软骨部面积比静态下测量的面积大(n P<0.05);Valsalva动作下,参数A所测得的软骨部面积大于参数B所测得的面积(n P<0.05);参数B的扫描时间长于参数A,差异有统计学意义(n P<0.05)。n 结论:仰卧位Vasalva动作下的STM测试配合CT参数A下的Valsalva扫描,可以Valsalva被动咽鼓管开放为共通点,互补反映咽鼓管形态及功能,既可呈现常规CT无法获得的咽鼓管开放管腔影像,又可对照观察咽鼓管的开闭过程,为咽鼓管研究提供了新手段。“,”Objective:In order to assess ET more comprehensively, sonotubometry (STM)combined with CT images were applied to investigate the opening features of eustachian tube (ET) in normal subjects. STM was also used as a monitor training ET opening maneuver and optimizing CT scan parameters.Methods:Following ET opening training monitored by STM, STM data of ET opening duration and maximum sound pressure from 13 healthy volunteers (10 males and 3 females, 22 to 26 years old) were acquired using maneuvers of swallowing and Valsalva in standing and supine positions. Two trials of CT scan, setting A (slice thickness 6.0 mm, manually simulated to 0.6 mm, reconstruction thickness 0.6 mm) for normal and Valsalva scans and setting B(slice thickness 0.4 mm,reconstruction thickness 0.4 mm)for Valsalva scan, were conducted in each subject. The bone area and cartilage area of ET were measured respectively in reconstructed CT images. Statistical software SPSS 19.0 was employed in data analysis.Results:The duration of ET opening and maximum sound pressure by Valsalva were longer and stronger than those by swallowing in both positions. For Valsalva maneuver, standing position resulted in longer ET opening duration compared to supine position (n P<0.05). Under setting A, ET cartilage area was measured larger by Valsalva scan than by normal scan (n P<0.05). By Valsalva scan, setting A captured larger ET cartilage area compared to setting B (n P<0.05). CT setting B resulted in longer scan time in comparison to setting A (n P<0.05).n Conclusions:Techniques of STM in supine position plus CT scan under setting A can be combined by Valsalva passive ET opening. Not only the invisible ET lumen through routine CT scan can be illustrated, but also relevant ET open-close process is shown, therefore, this study provides the technique for ET research of function and structure.