Abstract: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… Show more
“…Incompletely mineralized bone, frequently visualized in the PA of the infants (below the age of 4 months), as a tiny hypodense focus on CT. 3 Typically seen along the anterior aspect of middle otic capsule extending into the PA, toward the petro-occipital fissure (Figure 1a). 7 Figure 1.1a Pseudolesions in a 1-month-old baby girl: Axial Computed tomography (CT) image reveals pericochlear hypodense foci (arrows) in the bilateral middle otic capsule extending into the petrous apex, toward petro-occipital fissure. Figure 1b;c & : Pseudofractures in a 10-month-old girl: Axial CT images show bilateral wide sub-arcuate canals (curved arrows in b) and prominent cochlear clefts (arrows in c).…”
Section: Normal Developmental Variants In Childrenmentioning
confidence: 99%
“…Non-ossified part of the mid-otic capsule, seen as a curvilinear lucency (Figure 1c) lateral to the apical turn of cochlea. 7 It can be identified in up to 41% of pediatric CTs and the incidence decreases with age. 9 It may represent an unobliterated space between the endosteal and periosteal layer of the otic capsule or may be related to the fissula-ante-fenestrum ( pericochlear lucency of fissula-ante-fenestrum ).…”
Section: Normal Developmental Variants In Childrenmentioning
confidence: 99%
“…Incompletely mineralized bone, frequently visualized in the PA of the infants (below the age of 4 months), as a tiny hypodense focus on CT. 3 Typically seen along the anterior aspect of middle otic capsule extending into the PA, toward the petro-occipital fissure (Figure 1a). 7…”
The petrous apex (PA) is involved in a myriad of pathological conditions, some of which are exclusive in children. Diagnosis may be difficult due to vague clinical presentation, and local examination is challenging owing to its inaccessible location. This is further complicated by multiple unfused sutures and ongoing PA pneumatization in children. Cross-sectional imaging is vital for the evaluation of the PA lesions, due to their precarious location and proximity to the major neurovascular structures. Several classification systems have been proposed for these lesions based on their site of origin, solid or cystic appearance, surgical or non-surgical (no touch lesions) management, and benign or malignant nature. In this article, we emphasize the distinctive role of different cross-sectional imaging modalities in the diagnosis of pediatric PA lesions, with special attention to normal variants that should not be mistaken for pathology. We also propose a radiological classification and algorithmic approach to aid in the precise diagnosis and facilitate appropriate management of the various PA lesions in children.
“…Incompletely mineralized bone, frequently visualized in the PA of the infants (below the age of 4 months), as a tiny hypodense focus on CT. 3 Typically seen along the anterior aspect of middle otic capsule extending into the PA, toward the petro-occipital fissure (Figure 1a). 7 Figure 1.1a Pseudolesions in a 1-month-old baby girl: Axial Computed tomography (CT) image reveals pericochlear hypodense foci (arrows) in the bilateral middle otic capsule extending into the petrous apex, toward petro-occipital fissure. Figure 1b;c & : Pseudofractures in a 10-month-old girl: Axial CT images show bilateral wide sub-arcuate canals (curved arrows in b) and prominent cochlear clefts (arrows in c).…”
Section: Normal Developmental Variants In Childrenmentioning
confidence: 99%
“…Non-ossified part of the mid-otic capsule, seen as a curvilinear lucency (Figure 1c) lateral to the apical turn of cochlea. 7 It can be identified in up to 41% of pediatric CTs and the incidence decreases with age. 9 It may represent an unobliterated space between the endosteal and periosteal layer of the otic capsule or may be related to the fissula-ante-fenestrum ( pericochlear lucency of fissula-ante-fenestrum ).…”
Section: Normal Developmental Variants In Childrenmentioning
confidence: 99%
“…Incompletely mineralized bone, frequently visualized in the PA of the infants (below the age of 4 months), as a tiny hypodense focus on CT. 3 Typically seen along the anterior aspect of middle otic capsule extending into the PA, toward the petro-occipital fissure (Figure 1a). 7…”
The petrous apex (PA) is involved in a myriad of pathological conditions, some of which are exclusive in children. Diagnosis may be difficult due to vague clinical presentation, and local examination is challenging owing to its inaccessible location. This is further complicated by multiple unfused sutures and ongoing PA pneumatization in children. Cross-sectional imaging is vital for the evaluation of the PA lesions, due to their precarious location and proximity to the major neurovascular structures. Several classification systems have been proposed for these lesions based on their site of origin, solid or cystic appearance, surgical or non-surgical (no touch lesions) management, and benign or malignant nature. In this article, we emphasize the distinctive role of different cross-sectional imaging modalities in the diagnosis of pediatric PA lesions, with special attention to normal variants that should not be mistaken for pathology. We also propose a radiological classification and algorithmic approach to aid in the precise diagnosis and facilitate appropriate management of the various PA lesions in children.
ObjectivesProviding insight for pediatric ear surgery via investigations on the development patterns of ossicles, mastoid, and external auditory canal (EAC).MethodsThis retrospective study analyzed high‐resolution computed tomography (HRCT) scans of 191 healthy temporal bones ranging from infants to adults. Subjects were grouped by 1‐year intervals for developmental regression models and 3‐year intervals for stage comparisons using t‐tests or Mann–Whitney U tests.ResultsThe size of auditory ossicles and tympanic cavity (TC) remained stable during development, while the minimum diameter of the tympanic sinus (TS) entrance was reduced. Regarding mastoid pneumatization, the air cells can be observed at birth, became pronounced at 2 years old, and were fully developed around the age of 5, with subsequent growth primarily involving radial expansion. Furthermore, the EAC demonstrated significant growth with age: the width of EAC increased linearly ( = 0.12x + 4.01, R2 = 0.85), while the length of EAC followed a polynomial growth pattern ( = −0.03x2 + 1.15x + 6.25, R2 = 0.96).ConclusionsOssicles and TC remain stable during development. Furthermore, mastoid air cells may have developed in the early stages of life, while their diameter increases synchronously with EAC. All in all, ossicular chain reconstruction surgery and endoscopic ear surgery can be performed in babies.Level of EvidenceNA Laryngoscope, 2024
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