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

Lo, Adeline; Nemec, Stefan F.

doi:10.1016/j.crad.2014.11.014

Cited by 24 publications

(26 citation statements)

References 84 publications

(152 reference statements)

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“…Temporal CT could clearly show whether the mastoid process, tympanic sinus, and tympanum have lesions involving middle cranial fossa, sigmoid sinus, bulb of jugular vein, facial nerve and other anatomical variations [8,9], providing important preoperative reference for otologists and guiding surgical operations. However, the teaching of temporal CT reading from the perspective and focus of otological surgeons has not been reported in the field of clinical teaching.…”

Section: Discussionmentioning

confidence: 99%

Application Effect of Reading List in Teaching of Temporal CT Reading

Wei

Fang

Wen

et al. 2020

Preprint

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Background Temporal CT is the most commonly used imaging data in the clinical work of otology. How to cultivate and improve the ability of residents to read images has become an important focus in clinical teaching. Our aim is to explore the application effect of reading list in the reading teaching of temporal CT for resident otologists. Methods The resident otologists were selected as subjects and randomly divided into a Group A and a Group B. Group A adopted reading list of temporal CT while Group B did not adopted reading list. The ability of student to read temporal CT was tested and evaluated. Results The scores and identification proficiency of temporal CT in Group A were significantly better than those in Group B after training. The evaluation in the learning interest, prediction ability of surgical risk, prevention of missed diagnosis and misdiagnosis risk, doctor-patient communication ability, standard organization of reading, self-confidence in reading, self-learning of reading, and satisfaction degree with reading teaching methods in Group A were better than those in Group B. Conclusion Application of reading list can improve the ability of resident otologists to read temporal CT and predict surgical risk, and help students cultivate the standard reading habits and enhance their interest in learning.

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Section: Discussionmentioning

confidence: 99%

Application Effect of Reading List in Teaching of Temporal CT Reading

Wei

Fang

Wen

et al. 2020

Preprint

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“…4 emphasizes the importance of preoperative management (meticulous ear dressing, otic drops, and/or antibiotics). Comprehensive evaluation, including medical history-taking, otoscopic examination, and a period of medical treatment prior to surgery, are critical, as is professional radiological assessment [ 15 ].…”

Section: Discussionmentioning

confidence: 99%

Efficacy of Tympanoplasty Without Mastoidectomy for Treating Chronic Otitis Media in Patients With Mastoid Cavity Opacification in Temporal Bone Computed Tomography Findings

Kim

Bae

Choo

et al. 2018

Clin Exp Otorhinolaryngol

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Objectives Combined mastoidectomy is generally preferred to tympanoplasty alone when treating patients with chronic otitis media (COM), particularly when temporal bone computed tomography (TBCT) shows that the mastoid cavity contains opacification of soft tissue density. However, in cases with Eustachian tube dysfunction, a mastoid cavity volume may be a burden to its function. We hypothesized that tympanoplasty alone might be better than tympanoplasty combined with mastoidectomy because soft tissue in the mastoid cavity is a sequel to a protective physiological response. Thus, we explored the efficacy of tympanoplasty without mastoidectomy in COM patients exhibiting mastoid air cell opacification on TBCT.Methods Between 2010 and 2014, a total of 33 patients, diagnosed with COM and with evidence of mastoid cavity opacification on TBCT, underwent tympanoplasty without mastoidectomy. All ears had been dry for ≥3 months before surgery. All procedures were performed by the same surgeon. We retrospectively analyzed the preoperative otoscopic findings, pre- and postoperative pure tone averages (PTAs; the mean of the values at 0.5, 1, 2, and 4 kHz), surgical procedures, and complications or recurrence.Results Of the 33 patients, 28 (84.8%) exhibited hearing improvement after surgery. The mean pre- and postoperative PTAs were 46.9±21.2 dB and 29.4±17.0 dB, respectively (P<0.001). The air-bone gap decreased from 25.7±10.7 dB to 10.3±8.7 dB (P<0.001). Thirty-two patients (97.0%) did not develop any COM recurrence or cholesteatoma; one patient developed attic retraction of the tympanic membrane. Other minor complications were transient otorrhea caused by myringitis (two cases) and a pinpoint perforation (one case).Conclusion Tympanoplasty alone, i.e., without mastoidectomy, may adequately control COM, if it shows dry-up status for at least 3 months even though mastoid cavity opacification is detected in TBCT.

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“…In the United Kingdom, elective radiological assessment of the temporal bone primarily is performed via CT. The capability of this imaging modality to produce thin anatomical cross sections allows detailed evaluation of temporal bone opacification and the ossicular chain . Despite this, much of the research into incidental disease has focused on findings identified through MRI because it provides excellent evaluation of the soft tissues and often is performed to rule out intracranial complications of temporal bone disease.…”

Section: Discussionmentioning

confidence: 99%

“…The capability of this imaging modality to produce thin anatomical cross sections allows detailed evaluation of temporal bone opacification and the ossicular chain. 24 Despite this, much of the research into incidental disease has focused on findings identified through MRI because it provides excellent evaluation of the soft tissues and often is performed to rule out intracranial complications of temporal bone disease. More recently, however, it has been suggested that MRI is not an effective tool for diagnosing acute inflammatory processes of the mastoid because it correlates poorly with clinical findings.…”

Section: Discussionmentioning

confidence: 99%