Imaging Review of the Temporal Bone: Part I. Anatomy and Inflammatory and Neoplastic Processes

Juliano, Amy F.; Ginat, Daniel Thomas; Moonis, Gul

doi:10.1148/radiol.13120733

Cited by 127 publications

(124 citation statements)

References 81 publications

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“…glomus tumor (most common), facial nerve schwannomas and geniculate region hemangiomas extending to middle ear, choristomas, and malignancies such as carcinomas and metastases (rare). 13 In the current CT scan study, three of the six tumors observed were glomus tympanicum tumors, more commonly in female patients than male (2:1), in line with literature. 10 The other tumors observed in this study were middle ear malignancy and EAC malignancy.…”

Section: Discussionsupporting

confidence: 89%

High resolution computed tomography of temporal bone in the evaluation of otologic diseases

Handi¹,

Patil

Nisha

2017

Int J Otorhinolaryngol Head Neck Surg

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INTRODUCTIONDue to the complex anatomy of the temporal bone, conventional radiological methods like X-ray mastoid have limited ability to delineate the details of the temporal bone and cochlea-vestibular anatomy and disease pathology. The availability of modern highresolution computerized tomography (HRCT) scanners has resulted in ability to demonstrate the detailed temporal bone anatomy and identify significant structures and has revolutionalized the role of radiology in diagnosis and management of temporal bone diseases. 1 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.

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Section: Discussionsupporting

confidence: 89%

High resolution computed tomography of temporal bone in the evaluation of otologic diseases

Handi¹,

Patil

Nisha

2017

Int J Otorhinolaryngol Head Neck Surg

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“…After the scan was taken, radiologist gave the detailed reporting of the temporal bone. 4 All the patients went through ear surgery and all the findings seen intra-operatively were noted. Both the radiological and surgical findings were tabulated and correlated with each other.…”

Section: Scanning Parametersmentioning

confidence: 99%

Middle ear cholesteatoma: a study of correlation between HRCT temporal bone and intraoperative surgical findings

Chavada¹,

Khavdu²,

Fefar³

et al. 2018

Int J Otorhinolaryngol Head Neck Surg

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INTRODUCTIONCholesteatoma is a long-standing infection of the middle ear cleft. It is a three-dimensional stratified squamous epithelial sac confirming to the middle ear cleft, containing keratin debris and having the capacity for progressive and independent growth at the expense of the underlying bone, displacing or replacing the middle ear mucosa, and has a tendency to recur after removal.1 It has a destructive nature that erodes the bone and causes rapid bone destruction. Cholesteatoma have characteristics of growth, migration and osseous erosion and are thus locally destructive, the only treatment is their full surgical removal since there is no effective clinical treatment for eradication of the disease so far. 2Chronic ear discharge and decreased hearing are most common clinical presentation in cholesteatoma disease. Other symptoms are tinnitus, earache, ear bleeding. Other warning symptoms are headache, high grade fever, vomiting, giddiness and facial asymmetry suggestive of intratemporal and intracranial complications. ABSTRACTBackground: Cholesteatoma is a long-standing infection of the middle ear cleft having erosive properties. Chronic ear discharge and decreased hearing are most common clinical presentation. Multi-directional tomography of high quality can provide a detailed understanding of the interpretation of anatomical structures visualized by HRCT. Knowledge of the anatomical variations and changes induced by pathology in the temporal bone are the guiding marbles for surgery. Methods: This is a prospective study consisted of 100 cases of chronic suppurative otitis media of unsafe type requiring ear surgery admitted in the E.N.T. department of P.D.U. Civil Hospital Rajkot in 2 years from December 2015 to December 2017. A total no. of 100 patients of both gender between 5 to 80 years has been included in the study. Results: In this study, 58% patients were females while males were 42%. Left ear (46%) was involved more as compared to right ear (40%). Most of the patients belonged to 11-20 (25%) years of age group. Mean age is 24.5 years. Most common symptoms were ear discharge (98%) and decreased hearing (83%). Conclusions: HRCT guides the surgeon on the possible surgical hazards before the surgery and helps in earlier management and operative complications. The use of CT in the case of chronic suppurative otitis media does provide valuable information. HRCT scanning is a unique method of detection of early cholesteatoma as well as detection of cholesteatoma in hidden areas. In addition, HRCT scanning serves as a road map to assist the surgeon during cholesteatoma surgery.

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“…A possible resulting subperiosteal abscess may lead to a rare Bezold abscess, where infection extends between the digastric and sternocleidomastoid muscles. 2,8,9 At MRI, AOM presents as tympanic and mastoid high T2-weighted (W) signal material. Contrast-enhanced MRI (CE-MRI) is useful in assessing complications, such as labyrinthitis seen as inner ear contrast-enhancement, dural venous sinus thrombosis with venous filling defects, extra-or intracranial abscess formation with a rim-enhancing collection, or meningitis with leptomeningeal enhancement 5 (Fig 1b).…”

Section: Introductionmentioning

confidence: 99%

“…This may cause deep facial pain with abducens nerve palsy, termed Gradenigo's syndrome, and should not be confused with the asymptomatic finding of trapped residual fluid within the petrous apex air cells. 8,10,11 The differential diagnosis includes cholesteatoma, cholesterol granuloma, and in children, Langerhans' cell histiocytosis (LCH). 2e3,12 However, cholesteatoma and cholesterol granuloma are typically associated with chronic otitis.…”

Section: Introductionmentioning

confidence: 99%

“…2,24,25 Patients may have conductive hearing loss, otorrhoea, tympanic membrane perforation, retraction, and/or visualized scarring at otoscopy. 8,25,26 Histology shows granulation tissue and hyperplastic mucosa. 25 On CT, granulation tissue deposition and longterm inflammatory damage translates into tympanic opacification with possible ossicular disruption, mastoid trabeculae thickening, sclerosis, and mastoid cell obliteration 8,25 (Fig 3a).…”

Section: Introductionmentioning

confidence: 99%

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Opacification of the middle ear and mastoid: imaging findings and clues to differential diagnosis

Nemec

2015

Clinical Radiology

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Imaging Review of the Temporal Bone: Part I. Anatomy and Inflammatory and Neoplastic Processes

Cited by 127 publications

References 81 publications

High resolution computed tomography of temporal bone in the evaluation of otologic diseases

High resolution computed tomography of temporal bone in the evaluation of otologic diseases

Middle ear cholesteatoma: a study of correlation between HRCT temporal bone and intraoperative surgical findings

Opacification of the middle ear and mastoid: imaging findings and clues to differential diagnosis

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