Imaging of the Temporal Bone

Abele, Travis A.; Wiggins, Richard H.

doi:10.1016/j.rcl.2014.09.010

Cited by 24 publications

(21 citation statements)

References 43 publications

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“…This is one of the important signs of cholesteatoma in epitympanum. Osseous erosion involving the scutum or ossicles is key to distinguishing a cholesteatoma from benign debris or otitis media on CT, although absence of erosion does not exclude cholesteatoma [27].…”

Section: Discussionmentioning

confidence: 99%

Is Routine Use of High Resolution Computerized Tomography of Temporal Bone in Patients of Atticoantral Chronic Suppurative Otitis Media without Intracranial Complications Justified?

Bathla

Doshi

Kansara

2017

Indian J Otolaryngol Head Neck Surg

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Role of high resolution computerized tomography (HRCT) of temporal bone is established in cases of atticoantral chronic suppurative otitis media (CSOM) with intracranial complications. Routine use of HRCT in management of patients of atticoantral CSOM without intracranial complications has been an issue of debate. The aim of this study was to evaluate the routine use of HRCT of temporal bone in such cases. This study was a prospective study done at LG hospital, AMC MET Medical College, Ahmedabad to evaluate and compare the temporal bone findings in HRCT and intraoperative findings in 100 patients with atticoantral CSOM. All patients underwent HRCT screening followed by surgical exploration of middle ear cleft. In extent of disease HRCT showed very high sensitivity and specificity for epitympanum (100, 94%) and mesotympanum (98, 98%) areas. It gave valuable information of disease extent in hidden areas like sinus tympani and facial recess of mesotympanum. HRCT satisfactorily delineated malleus and incus erosion but had 75% sensitivity for detecting erosion of stapes suprastructure, though specificity was of 97%. For bony anatomical landmarks HRCT showed very high sensitivity and specificity for detecting erosion of lateral semicircular canal, tegmen tympani and sinus plate. Detection of facial canal erosion on HRCT had moderate sensitivity of 75%. We concluded that routine use of HRCT is justified as a reliable preoperative tool in patients with atticoantral CSOM without intracranial complications and it helps to plan type of surgical intervention. HRCT has limited role to distinguish between granulations and cholesteatoma and also to delineate stapes supra structure and facial nerve canal.

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Section: Discussionmentioning

confidence: 99%

Is Routine Use of High Resolution Computerized Tomography of Temporal Bone in Patients of Atticoantral Chronic Suppurative Otitis Media without Intracranial Complications Justified?

Bathla

Doshi

Kansara

2017

Indian J Otolaryngol Head Neck Surg

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“…Recently, the role of imaging in vestibular disorders changed, as the application of gadolinium-based contrastenhanced magnetic resonance (MR) imaging of the inner ear enabled the in vivo visualization of EH [6]. Nowadays, some clinics use the combination of symptomatology and hydrops imaging to improve their diagnostic trajectory for vestibular disorders [7], with emphasis on MD. The development of hydrops imaging also resulted in the proposal of new classification methods for vestibular entities like MD.…”

Section: Electronic Supplementary Materialsmentioning

confidence: 99%

“…MR imaging is nowadays the most commonly used method to detect EH in clinic [7]. The high prevalence of EH (82.3%) detected in patients with MD underlines the potential diagnostic value of hydrops imaging.…”

Section: The Challenges Of Hydrops Imaging In Vestibular Disordersmentioning

confidence: 99%

The “hype” of hydrops in classifying vestibular disorders: a narrative review

et al. 2020

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Background Classifying and diagnosing peripheral vestibular disorders based on their symptoms is challenging due to possible symptom overlap or atypical clinical presentation. To improve the diagnostic trajectory, gadolinium-based contrast-enhanced magnetic resonance imaging of the inner ear is nowadays frequently used for the in vivo confirmation of endolymphatic hydrops in humans. However, hydrops is visualized in both healthy subjects and patients with vestibular disorders, which might make the clinical value of hydrops detection on MRI questionable. Objective To investigate the diagnostic value of clinical and radiological features, including the in vivo visualization of endolymphatic hydrops, for the classification and diagnosis of vestibular disorders. Methods A literature search was performed in February and March 2019 to estimate the prevalence of various features in healthy subjects and in common vestibular disorders to make a graphical comparison between healthy and abnormal. Results Of the features studied, hydrops was found to be a highly prevalent feature in Menière’s disease (99.4%). Though, hydrops has also a relatively high prevalence in patients with vestibular schwannoma (48.2%) and in healthy temporal bones (12.5%) as well. In patients diagnosed with (definite or probable) Menière’s disease, hydrops is less frequently diagnosed by magnetic resonance imaging compared to the histological confirmation (82.3% versus 99.4%). The mean prevalence of radiologically diagnosed hydrops was 31% in healthy subjects, 28.1% in patients with vestibular migraine, and 25.9% in patients with vestibular schwannoma. An interesting finding was an absolute difference in hydrops prevalence between the two diagnostic techniques (histology and radiology) of 25.2% in patients with Menière’s disease and 29% in patients with vestibular schwannoma. Conclusions Although the visualization of hydrops has a high diagnostic value in patients with definite Menière’s disease, it is important to appreciate the relatively high prevalence of hydrops in healthy populations and other vestibular disorders. Endolymphatic hydrops is not a pathognomic phenomenon, and detecting hydrops should not directly indicate a diagnosis of Menière’s disease. Both symptom-driven and hydrops-based classification systems have disadvantages. Therefore, it might be worth to explore features “beyond” hydrops. New analysis techniques, such as Radiomics, might play an essential role in (re)classifying vestibular disorders in the future.

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“…Though UHF-MRI can produce transient vestibular dysfunction in humans, it is believed to be safe overall with technical, financial, and legislative limitations remaining the primary obstacles impeding more widespread use (see Supplemental Digital Content 4, Discussion). 8,14–19 …”

Section: Discussionmentioning

confidence: 99%

Ultra-High-Field Magnetic Resonance Imaging of the Human Inner Ear at 11.7 Tesla

Thylur¹,

Jacobs

Go³

et al. 2017

Otology &Amp; Neurotology

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Objective To evaluate the ability of ultra-high-field magnetic resonance imaging (UHF-MRI) at 11.7 Tesla to visualize membranous structures of the human inner ear. Specimens Three temporal bones were extracted from cadaveric human heads for use with small-bore UHF-MRI. Intervention Ex vivo cadaveric temporal bone specimens were imaged using an 11.7 T MRI scanner via T1- and T2-weighted-imaging with and without contrast. Main Outcome Measure Qualitative visualization of membranous components of the inner ear compared with reports of UHF-MRI at lower field strengths. Results The membranous anatomy of the inner ear was superbly visualized at 11.7 T. In the cochlea, Reissner’s membrane, the scala media, and the basilar membrane were clearly shown on the scan. In the vestibular labyrinth, the wedge-shaped crista ampullaris and the maculae of both the saccule and utricle were visible. Details of the endolymphatic sac and duct were also demonstrated. Conclusion To our knowledge, this report presents the first images of the ex vivo human inner ear using 11.7 T UHF-MRI, offering near-histologic resolution. Increased field strength may be particularly useful when imaging the delicate membranous anatomy of the inner ear. Further research on the use of UHF-MRI in clinical and research settings could illuminate structural changes associated with inner ear disorders.

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Imaging of the Temporal Bone

Cited by 24 publications

References 43 publications

Is Routine Use of High Resolution Computerized Tomography of Temporal Bone in Patients of Atticoantral Chronic Suppurative Otitis Media without Intracranial Complications Justified?

Is Routine Use of High Resolution Computerized Tomography of Temporal Bone in Patients of Atticoantral Chronic Suppurative Otitis Media without Intracranial Complications Justified?

The “hype” of hydrops in classifying vestibular disorders: a narrative review

Ultra-High-Field Magnetic Resonance Imaging of the Human Inner Ear at 11.7 Tesla

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