Imaging of temporal bone inflammations in children: a pictorial review (original) (raw)
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European Journal of General Medicine, 2011
Aim: Computerized tomography (CT) examination of temporal bone is a routine procedure in the diseases of the middle ear. The aim of this study is to establish the efficacy of CT in the diagnosis of the complications due to inflammatory pathologies of middle ear. Method: Patients with suspected middle ear pathology were undergone temporal CT examination between August 2006-June 2008. 56 patients who underwent operation with various complications due to chronic otitis media and choleostatoma were included in the study group. Complications that developed chronic inflammation secondary were established as tympanosclerosis, ossicle erosion, scutum erosion, tegmen erosion, irregularity in mastoid bone cortex and contour of facial nerve, semicircular canal defect and chronic mastoiditis.
External and middle ear diseases: radiological diagnosis based on clinical signs and symptoms
Insights into Imaging, 2011
Objective Pathology of the external and middle ear is the most frequent reason to prescribe antibiotics and perform surgery in children and young adults. In the majority of cases imaging studies are not performed; the need for imaging comes when complications are suspected or when treatment is not effective. This paper discusses indications for temporal bone imaging studies and presents the most frequent pathological conditions, together with differential diagnosis, clinical symptoms and methods of treatment.
High resolution computed tomography of temporal bone in the evaluation of otologic diseases
International Journal of Otorhinolaryngology and Head and Neck Surgery, 2017
HRCT is particularly helpful in evaluating the anatomy and pathology of external auditory canal, middle ear cavity, vestibular aqueduct, tegmen tympani, sigmoid sinus plate, vertical segment of facial nerve canal, sinodural angle, carotid canal, jugular fossa, infra and supralabrynthine air cells and temporomandibular joint; both soft tissue extension and significantly sensitive ABSTRACT Background: Conventional radiological methods like X-ray mastoid have limited ability to delineate the details of the complex temporal bone and cochlea-vestibular anatomy and disease pathology. This can be overcome by the use of High resolution computed tomography (HRCT) evaluation of the temporal bone. HRCT is helpful in evaluating the anatomy and pathology type and extent of disease, thereby helps in preoperative planning. Methods: The CT scan of forty five patients attending the outpatient department of otorhinolaryngology in a tertiary care centre between August 2014 to August 2017 was evaluated in this study. Each CT scan was interpreted by an otolaryngologist and a radiologist and interpretation was by consensus. The data collected was evaluated and results are reported as rates and proportions (%). Results: The study evaluated CT scan of 45 patients of which 35 were male patients and 10 were female patients with age ranging from 5 years to 75 years. Most of these patients belonged to the 21-30, 31-40 age groups [9 (20%) in each group]. Infections of middle ear cleft (all with cholesteatoma), fractures of the temporal bone, anomalies and tumors of the external auditory canal and middle ear were the pathologies observed in these CT scans with infection (otomastoiditis) [23 (51.1%)] being the most common pathology observed. Conclusions: Pre-operative CT scan may not only help in identifying the nature, extent of infectious disease including ossicular, bony erosions; it may also identify anomalies in the temporal bone and surrounding structures. Thus, HRCT temporal bone will help the surgeon in planning effective surgical strategy, reducing morbidity during the surgery.
2016
BACKGROUND AND OBJECTIVES: To study the HRCT temporal bone findings in chronic middle ear infections with reference to its extent and complications. MATERIALS AND METHODS: After an initial clinical assessment, 30 patients diagnosed clinically with chronic suppurative otitis media (CSOM) were referred for a HRCT of temporal bone which was done with a Siemens’ 16 slice MDCT scanner. RESULTS: Of the 30 patients, 60% were males and 40% were females. Otorrhoea (100%) is the most common symptom. Scutum was eroded in 23 cases. Malleus (18 cases) is the most commonly eroded among the ossicles. Mastoiditis and mastoid abscess (22%) was the most common complication of CSOM followed by Malleus head erosion (60%). Intracranial complications like abscess, Dural sinus thrombosis (4%), Facial canal Dehiscence (4%) , Tegmen tympani Erosion (2%). Cochlea erosion, Tegmen mastoideum Erosion, Lateral semicircular canal erosion were not observed in any of the cases. Cholesteatoma were observed in 30 cas...
International Journal of Otorhinolaryngology and Head and Neck Surgery
Background: High Resolution Computed Tomography (HRCT) has widely replaced conventional techniques (X-Ray Mastoid bone) for temporal bone imaging. The most significant use of computed tomography lies in evaluation of cases of Chronic Suppurative Otitis Media (CSOM). The objective of the study was to evaluate the usefulness of HRCT scanning of temporal bone in defining the extent and severity of disease in patients with CSOM, thereby altering the surgical plan and outcome. Methods: This prospective study was conducted at a tertiary care hospital in Ahmedabad. After obtaining approval from IEC (Institutional Ethical Committee), study was carried out on 50 patients diagnosed with CSOM of atticoantral type. Written informed consent of all patients was taken before enrollment in the study. HRCT scan findings were reviewed and correlated with per-operative findings. Results: Out of total 50 patients of CSOM, 26 (52%) were males. Majority of the patients (70%) were in the age group of 11 to 30 years. Left ear was involved in 40% of the patients. Majority of the patients (80%) presented with chief complaint of otorrhoea. In the present study, External Auditory Canal (EAC) was seen normal in majority of patients (82%) both radio logically and per operatively. HRCT scan was found to be very sensitive (96%) in diagnosing cholesteatoma. The sensitivity of HRCT for diagnosing disease in epitympanum, antrum and aditus was found to be 100%, 97% and 88% respectively. CT scans diagnosed erosion of malleus with 100% sensitivity and specificity and erosion of incus with 91% sensitivity and 100% specificity. Conclusions: HRCT was helpful in determining the anatomy of the middle ear and mastoid, and accurately predicted the extent of the disease process of CSOM.
IOSR Journals , 2019
Introduction :Chronic Suppurative Otitis Media is defined as a chronic inflammation of the middle ear and mastoid cavity. It is classified into 1) inactive mucosal disease, 2) active mucosal disease, 3) inactive squamosal disease, 4) active squamosal disease, 5) healed chronic otitis media. Chronic otitis media with cholesteatoma is a locally invasive disease that requires surgical intervention for definitive eradication of the disease. High resolution CT Scans are widely used to 1) understand the anatomic information, 2) know the extent of disease, 3) relationship of destruction to the anatomical structures. Aims and Objectives: To identify high resolution computed tomography (HRCT) scan findings of temporal bone in chronic inflammatory diseases of the middle ear ,to identify preoperative findings and to evaluate any correlation between scan findings and surgical and functional outcome of the surgery. Materials and methods: This study was conducted on a group of 50 patients with Chronic Otitis Media. A thorough ENT clinical and otoscopic examination was done on all patients. HRCT scan was ordered and interpreted for all the patients. Surgical intervention was done. Post-operatively all the patients were subjected to pure tone audiometry and Health related Quality of Life Questionnaire in the pre and post operative period after 3 months to evaluate functional outcome. Results: It was observed that 32% of the patients were aged between 11-20 years, male to female ratio was 2.1 : 1, erosion of the head and the handle of malleus were found in 34% and 10% on HRCT scan respectively. Incus body and the long process were found to be eroded in 26% and 62% of cases on HRCT scan and stapes suprastructure was found eroded in 36% of cases on HRCT scan. Conclusion: This study supports the role of HRCT scan in all cases of chronic suppurative otitis media to know the status if ossicular chain for the best treatment strategy.
Computed Tomography of the Petrous Bone: Particularities in Children
Advances in Molecular Imaging, 2018
Like any organ in children, the ear has particular anatomical features that are well shown in imaging. The petrous bone computed tomography (CT) is a valuable tool for diagnosing ear pathologies and evaluating surgical possibilities. In children, the ear has the peculiarity of having the morphology and size of adults, and the only difference resides in the components of the middle and inner ear related to the growth of the temporal bone and the state of ossification which are progressive with age. Some aspects of growth can simulate pathology and must be known. The pneumatisation of the temporal bone occurs gradually after birth and in several outbreaks until adulthood. The external auditory canal, the internal auditory meatus and the petromastoid canal progressively reach the adult aspect because of the growth of the petrous bone. This work aims to highlight the particularities of the petrous bone CT in pediatrics, since it has become widely used in the exploration of malformations, trauma, infectious complications of the ear and in the assessment of deafness.
An Exploratory Study of High Resolution Computed Tomography of Temporal Bone in Chronic Otitis Media
Nepalese Journal of Radiology
Introduction: Among various modalities used in the evaluation of chronic otitis media, HRCT of the temporal bone is the most reliable and valuable imaging modality as it provides excellent anatomic information. It can display minute anatomical and pathological details by providing a direct visual window into the temporal bone. Methods: This is a prospective cross-sectional study done at the department of Radiodiagnosis and imaging of Birat Medical College, Teaching hospital over 1 year with a total of 50 patients enrolled in the study. The findings were compared with the post-operative findings and data were entered. HRCT was done on 64 slices of multidetector CT scan. Sensitivity, specificity, positive predictive value, negative predictive value and accuracy of various parameters were calculated. Results: Out of 50 patients were enrolled in this study. Among them 52%(26) were females and 48%(24) were males. HRCT showed 100% sensitivity for the lateral semicircular canal and sigmoid...