The petromastoid canal in the young child: Appearance on computed tomography (original) (raw)
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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.
The petromastoid canal on computed tomography
European radiology, 2002
The objective was to assess visibility and anatomy of the petromastoid canal in high-resolution CT. Computed tomography images of 188 patients were reviewed for delineation of the petromastoid canal. This bony canal connects the mastoid antrum with the cranial cavity and houses the subarcuate artery and vein. The diameter, obtained in the middle portion of the canal, was compared with the diameter of the vestibular and cochlear aqueduct in all patients, and absolute values measured in 20 cases. Collimation was 1 mm in 164 and 2 mm in 24 examinations. Additionally, temporal bone of a cadaver was imaged and microdissected. The petromastoid canal was identified bilaterally in all 164 scans that were obtained with a slice thickness of 1 mm. In 5 of the 24 patients imaged with a collimation of 2 mm, the canal was not visible, most probably due to partial-volume effects. The petromastoid canal had the same diameter as the cochlear aqueduct in 42/44 (right/left), exceeded it in 66/61 and w...
International Journal of Pediatric Otorhinolaryngology, 1995
Secretory otitis media (SOM) is a disease of childhood, and this period is characterized by active growing of the craniofacial skeleton (CFS). In this study, we purposed to answer the question ‘how deviations in CFS play a role in ethiopathogenesis of SOM’? Therefore, we evaluated the ‘mastoid-middle ear-Eustachian tube (M-ME-ET) system’ in 30 SOM cases and 30 healthy children by using lateral cephalographies on which reference points and one line related to CFS and ‘M-ME-ET system’ were pointed. The results disclosed that the bony Eustachian tube, the vertical portion of the tensor veli palatini (TVP) muscle and the mastoid air cell system were smaller in SOM cases. In the view of the statements of Enlow (1990) on craniofacial growth, we suggest that the deviations in the growth process of the nasomaxillary complex lead to corresponding imbalances in the bony tube and vertical portion of the TVP. However, since regional imbalances often tend to compensate for one another to provide functional equilibrium (Enlow, 1990), improvement of the tubal function occurs with age.
Morphometric properties of the facial canal in children: A retrospective computed tomography study
International Journal of Pediatric Otorhinolaryngology, 2019
The main objective of the study was to examine the morphometric development of the facial canal in temporal bones aged from one to 18 years for pediatric otosurgeons and neurosurgeons. Methods The study was performed on 41 patients including cochlear implantation cases (20 females and 21 males) with a mean age of 6.44±5.79 years. All the measurements belonging to the facial canal including the length, width and angles of its segments were performed using the data of computed tomography assessment. Results The numerical data of the facial canal segments were not different in terms of sexes or sides, statistically (p>0.05). The width of the labyrinthine segment (p=0.145), the length of the tympanic segment (p=0.555), the first (p=0.067) and second (p=0.060) genu angles seemed to reach adult size at two years of age. In addition, the length of the labyrinthine segment (p=0.064) and the width of the mastoid segment (p=0.264) seemed to attain adult size at four years, while the width of the meatal foramen (p=0.264) seemed to arrive adult size at seven years. However, the length of the mastoid segment and the width of the tympanic segment were developing independently of increasing age between 1-18 years. Conclusion Our data suggested that, contrary to the general acceptance in the literature, the dimension of the facial canal segments show remarkable changes during the transition from intrauterine life to adult life. The regression equations representing the facial canal growth dynamic in children may be useful for otosurgeons to estimate the size of its segments and to prevent iatrogenic injury during early childhood surgeries such as cochlear implantation.
The Journal of Laryngology & Otology, 1992
The relationship between temporal bone pneumatization and the location of the lateral sinus and length of the mastoid process was investigated in 60 fresh frozen adult temporal bones, by plain X-rays, computed tomography and surgical dissection including otomicroscopic findings. Temporal bone pneumatization was classified as small, moderate and large. After drilling, the shortest distances between the middle fossa dura and mastoid tip representing the mastoid length and between the sigmoid sinus and posterior border of external auditory canal were measured and compared to the degree of pneumatization. The distances in the specimens with pathological eardrum and adhesions in the middle ear were compared to the ones without gross pathology. The length of mastoid process was significantly shorter in specimens with small pneumatization than those with large (Mann Whitney P<0.001).The specimens with a pathological eardrum and middle ear adhesions had a significantly shorter mastoid le...
International Journal of Otorhinolaryngology and Head and Neck Surgery, 2020
Background: Chronic otitis media (COM) affects 0.5-30% of individuals in any community and over 20 million people are estimated to suffer from this condition worldwide. COM often evolves in a continuum. Squamosal disease is more commonly found in poorly pneumatized bones, but whether the sclerosis is relevant to the etiology of the disease or is caused by it, has not been fully resolved. Our study aimed at comparing the mastoid pneumatization patterns obtained using X-ray mastoid and high-resolution computed tomography (HRCT) temporal bone. It was an interventional study.Methods: Sixty patients of unilateral squamosal COM, aged more than 8 years, underwent X-ray mastoid Schuller’s view and HRCT temporal bone, using Philips extended brilliance 48 slice CT. Results: Upon analysis, in diseased and healthy ears, the coincidence of X-ray and HRCT findings was 63.33% and 80% respectively.Conclusions: HRCT temporal bone should be done in all cases of squamosal COM to know the extent of th...
Otitis media and its correlation to craniofacial morphology
International Congress Series, 2003
Otitis media is more common in children and craniofacial growth influences the growth of the auditory tube. So there should be a correlation between craniofacial morphology and otitis media. The aims of this study are to correlate facial types and cephalometric measurement morphology to otitis media and to suggest which measurement can be used as a prediction of the evolution of otitis media. Sixty-six patients, 18-40 years old, were selected. They were divided into two groups: 32 with otitis media and 34 controls. We excluded patients with personal or familiar history of cleft palate, previous buccal, maxillar, pharyngeal, facial or nasal surgery, orthodontic treatment or obstructive process of the auditory tube ostia. All subjects underwent an ENT physical examination and lateral cephalograms. Statistical analysis of the cephalometric measurements showed significant differences of cranial base; projection of maxilla and facial height in patients with otitis media when compared to the control group or to the ideal measures of the harmonic face. There was no predominance of any facial type. The following measures were found to be predictive of the evolution of otitis media: N-S (anterior cranial base), N-S.Ba (angle between anterior and medial cranial base), PMax (projection of the maxilla) and N-ANS (superior anterior facial height).
Many clinical and experimental studies have been done to analyze the ana tomical and functional aspects of the internal auditory canal (IAC) in human beings since there are great inter-individual variability and structural variations that may occur regard ing the other adjacent structures. Objectives: The purpose of this study was to characterize the morphology of the internal auditory canal (IAC) during development using high resolution computed tomography (CT) and to analyze its dimensions, which will be determined by measuring the nearby areas and structures using a system of digital image processing. Patients and Methods: CT images of the IAC of 110 normal subjects aged 1 to 92 years (mean age, 46.5 years) of both genders were reviewed to determine the shape, area, open ing width (OW), longitudinal length (LL), vertical diameter (VD) and distance from the ves tibular aqueduct. Results: The shapes observed in children and adults were funnel-shaped (74% and 58.3%, respectively), cylindrical (22% and 30.9%, respectively) and bud-shaped (4% and 10.8%, re spectively). The measurements by CT in children were: area= 50.30 mm 2 , OW = 7.53 mm, length = 11.17 mm, VD = 4.82 mm and the distance between the IAC and the vestibular aque duct (VA) = 12.63 mm. In adults, the measurements were: area = 44.64 mm 2 , OW = 7.10 mm, length = 9.84 mm, VD = 4.47 mm and the distance between IAC and VA = 11.17 mm. Conclusions: CT images showed that the IAC has different shapes and when the measure ments obtained for children were compared with those of adults, the parameters that pre sented statistically significant differences in either gender were length and diameter.
Cranial Indicators Identified for Peak Incidence of Otitis Media
Anatomical record (Hoboken, N.J. : 2007), 2017
Acute otitis media (AOM) is one of the most common pediatric conditions worldwide. Peak age of occurrence for AOM has been identified within the first postnatal year and it remains frequent until approximately six postnatal years. Morphological differences between adults and infants in the cartilaginous Eustachian tube (CET) and associated structures may be responsible for development of this disease yet few have investigated normal growth trajectories. We tested hypotheses on coincidence of skeletal growth changes and known ages of peak AOM occurrence. Growth was divided into five dental eruption stages ranging from edentulous neonates (Stage 1) to adults with erupted third maxillary molars (Stage 5). A total of 32 three-dimensional landmarks were used and Generalized Procrustes Analysis was performed. Next, we performed principal components analysis and calculated univariate measures. It was found that growth change in Stage 1 was the most rapid and comprised the largest amount of...
Correlation of HRCT mastoid with clinical presentation and operative findings in ear diseases
International Journal of Otorhinolaryngology and Head and Neck Surgery
The human temporal bone has an extremely complex structure. Direct axial and coronal CT sections are quite satisfactory for imaging the anatomy of the temporal bone but most of the normal and pathological details of the temporal bone are better visualized with direct sagittal CT sections. The sagittal projection is of interest for surgeons, as it has the advantage of following the plane of surgical approach. HRCT is found to be extremely useful for evaluating the diseases involving the external auditory canal, middle ear cavity, vertical segment of facial nerve canal, vestibular aqueduct, tegmen tympani, sigmoid sinus plate, sinodural angle, carotid canal, jugular fossa, infra and supralabrynthine air cells and temporomandibular joint. HRCT has contributed greatly to an understanding of the complex anatomy and spatial relationship of the minute structures of hearing and balance organs, which are packed into a small pyramidshaped petrous temporal bone. HRCT shows not only soft tissue extension but also gives a more sensitive demonstration of calcification. It has also become useful ABSTRACT Background: HRCT is found to be extremely useful for evaluating the ear diseases involving the external auditory canal, middle ear cavity, vertical segment of facial nerve canal, vestibular aqueduct, tegmen tympani, sigmoid sinus plate, sinodural angle, carotid canal, jugular fossa, infra and supralabrynthine air cells and temporomandibular joint. Our main objective was to correlate the clinical presentation and operative findings of ear diseases with HRCT mastoid. Methods: This study is done in our institute otorhinolaryngology dept. from April 2014 to April 2016. This is prospective study involves 36 patient belonging to different age and sex groups with high suspicious of ear diseases. We have taken detail history of each patient with complete ear nose throat examination done and after that all patient were investigated with routine blood investigation, X-ray and HRCT mastoid to correlate clinical finding and subjected for operation to compare operative findings with HRCT finding. Results: Determined using Pearson chi square test indicated a statistically significant correlation between HRCT temporal bone with clinical presentation and operative findings of ear diseases (p<0.05). Conclusions: With the advent of modern high-resolution CT scanners, detailed demonstration of temporal bone anatomy is practically possible now. We have been able to identify many significant structures not demonstrated by any of the known imaging modalities. The improved contrast and soft tissue a definition possible with HRCT has resulted in production of excellent images of soft tissue lesions in air spaces. Hence HRCT appears to be the diagnostic modality of choice for cholesteatomas and other soft tissue lesions in middle ear.