High-resolution computed tomography of the temporal bone: Its role in the evaluation of middle ear disease (original) (raw)
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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.
International Journal of Advances in Medicine, 2019
Background: Prior to surgery it is very important that the surgeon is fully aware, and he should have the clear picture as to the extent of the disease and the nature of the disease to give satisfactory surgical outcomes for the patient. HRCT (High resolution computed tomography) is one such guiding tool for the surgeon. The objective was to study usefulness of HRCT scan in attico-antral disease in depicting the status of the middle ear structures.Methods: A total of 30 patients were studied. HRCT temporal bone was performed by using SIEMENS EMOTION 16 slice CT machine in axial plane and coronal images were reformatted. Findings of HRCT temporal bone were recorded. Findings of mastoid exploration surgery were recorded. Report of HRCT of temporal bone was correlated with surgical findings and tabulated using percentages.Results: Surgery showed cholesteatoma in 26 (86.6%) patients. Epitympanum was involved in 29 (96.6%) patients in HRCT and 30 (100%) patients at surgery. Extension b...
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.
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...
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.
ROLE OF HIGH RESOLUTION COMPUTED TOMOGRAPHY IN THE EVALUATION OF TEMPORAL BONE LESIONS
Asian Journal of Pharmaceutical and Clinical Research Journal, 2022
Objectives: The study's primary goal is to assess inflammatory, traumatic, and neoplastic disorders that impact the temporal bone using high resolution computed tomography (HRCT). The other aim is to comprehend how HRCT can diagnose and detect pathologies of the temporal bone. Methods: The study was conducted at Dr. Patnam Mahender Reddy Institute of Medical Sciences from Jan 2018 to Jan 2020 with a sample size of 60. Written consent for participation in the study was taken before the scan. The study was evaluated with multidetector HRCT-HITACHI 128 SLICE machine. CT images are usually acquired or displayed in axial and coronal planes. Results: Among 60 patients, 44 patients were diagnosed with infections, 11 were diagnosed with tumors, and five patients with anatomical variants. Among 60 patients, 32 (53.3%) were male patients, and 28 (46.6%) were female patients; hence, study shows a male preponderance. Out of 60 patients, the highest number was recorded in those aged 21-30 years 16 (36%). Among 60 patients, 44 suspected of having a middle ear infection were studied. Among these 44 patients, 27 (61.3%) were diagnosed with otomastoiditis, 16 (36%) patients were diagnosed with cholesteatoma, and 1 (2.2%) patient was diagnosed with malignant otitis externa. In our study population of 60 patients, 11 were diagnosed with neoplasms. Among the 11 patients, 7 (67%) were diagnosed with acoustic neuroma in the cerebellopontine angle. Conclusion: The existence of cholesteatoma, changes to the ossicular chain, and erosion of the lateral semicircular canal were all intraoperatively detected in the present study with excellent sensitivity to the clinical and radiographic findings. For correcting any congenital ear anomalies, the HRCT results were helpful for planning and management tools for the surgeon.
Analytical Study of Temporal Bone Pathologies and Anatomical Variations on High Resolution CT
Asian Journal of Medical Radiological Research, 2019
Background: High Resolution Computed Tomography (HRCT), a modification of routine CT, owing to its ability to delineate intricate osseous anatomy and admirable topographic visualization, is widely used for accurate assessment of temporal bone pathologies prior to surgical exploration. The present study was undertaken to evaluate temporal bone in diseased ears by HRCT and its importance in patient management. Subjects and Methods: This prospective study was conducted in the department of Radiodiagnosis of a large tertiary care hospital in Northern India. A total of 50 patients with clinically proven middle ear disease with hearing loss or chronic suppurative otitis media (CSOM) were enrolled into this study. All cases were evaluated with 128 slice CT scanner (Philips Medical systems, Cleveland, USA). Results: Mean age of patients in our study was 29.52 ± 21.48 years. Maximum patients with temporal bone pathologies had either sclerosed or under-pneumatized mastoids. Limited numbers of anatomical variations were noted with Korner's septum being the most common variation (7.14 %). Others variations included high jugular bulb (2.86 %), facial nerve dehiscence (2.86 %), labyrinthine fistula (2.86 %) and foramen tympanicum (1.43 %). Otomastoiditis was the most frequently encountered pathological condition in the study population (72.86 %), followed by cholesteatoma (32.86 %). Congenital malformations were seen in 10 cases (14.29%) with type I incomplete partition (5.71%) being the most common malformation. Conclusion: HRCT of temporal bone is useful in identifying common ear pathologies and anatomical variations prior to the surgery and thereby planning appropriate surgical approach.
Journal of Evolution of Medical and Dental Sciences
High Resolution Computed Tomography (HRCT), a modification of routine CT, provides a direct visual window in the temporal bone providing minute structural details. Purpose of the present study was to evaluate the suppurative diseases of middle ear and mastoid with their complications on HRCT and to correlate these imaging findings surgically. Our study shows good correlation of various HRCT findings in suppurative diseases of middle ear & mastoids with intra-operative findings. MATERIALS AND METHODS This retrospective study included 60 patients who were referred to the Department of Radiodiagnosis, Assam Medical College with clinically suspected temporal bone or ear pathologies. After detailed clinical examination, the patients were subjected to HRCT examination. The imaging findings of all cases were correlated with the surgical findings. RESULTS Out of 60 patients, 63.3% had unsafe CSOM with cholesteatoma. The HRCT findings with surgical correlation showed a high 91.89% sensitivity for identifying cholesteatoma. HRCT also provided good sensitivity for detecting erosion of scutum (90.32%), erosion of ossicular chain (86.96%) and erosion of lateral semi-circular canal (80%). HRCT had lower sensitivity (66.67%) for identifying facial canal dehiscence. CONCLUSION The HRCT findings showed a good sensitivity with intraoperative findings in identification of cholesteatoma, erosion of scutum, ossicular chain and semi-circular canal.
© American Society of Neuroradiology CT of the Temporal Bone in
1987
In an attempt to better define the changes affecting the temporal bone that might predispose achondroplastic dwarfs to otitis media, nine achondroplastic subjects who were evaluated for hearing loss underwent high-resolution CT scanning of the temporal bone. Comparisons were made with 10 nonachondroplastic subjects. A number of morphologic changes were seen, including (1) poor development of mastoid air cells, (2) foreshortening of the carotid canals, (3) narrowing of the skull base, (4) "towering" petrous ridges, and (5) relative "rotation " of the cochlea and other temporal bone structures. The most significant change was the rotational effect, which was more pronounced medially, resulting in an abnormal orientation of inner ear structures relative to middle ear structures and of middle ear structures relative to the external auditory canal. There was a notable lack of evidence for otitis media or its sequelae in any of the achondroplastic subjects. Audiograms ...