Background:
Many imaging modalities have been in use for the evaluation
of temporal bone lesions. Plain X-rays are cost-effective
however; they provide limited details and hence sometimes
may result in an inaccurate diagnosis. With the advent of HRCT,
the method of imaging of temporal bone has evolved with
special algorithms and multiplanar formats. In the present
study, we tried to evaluate the different pathologies of the
temporal bone with X-ray and HRCT.
Methods: The study was conducted in the Departments of
Otorhinolaryngology and Radiology, Prathima Institute of
Medical Sciences, Naganoor, Karimnagar. A total of n=40
patients were identified and selected based on their symptoms
and clinical findings suggestive of a lesion involving the
temporal bone such as Otalgia, Otorrhoea, And
Sensorineuronal deafness, pulsatile tinnitus, vertigo, and
giddiness. These patients were subjected to high resolution
computed tomography of the temporal bone on the 128 Slice
CT Scanner (PHILIPS INGENUITY). The patients also underwent
plain Radiography of temporal bone (CARESTREAM DRX-1
System).
Results: Of the total n=40 patients studied the most common
temporal bone disease was due to inflammation 85% and
tumors were found in 15% of the patients. The common site
of involvement of middle ear and mastoid air cells in chronic
otitis media was epitympanum in n=30(90%) of cases,
Mesotympanum in n=20(60%) of cases. In diseased ears,
radiographs of the mastoids revealed pneumatised mastoid in
6(15%), diploic in 6(15%), and sclerosed mastoid in 28(70%)
cases. HRCT temporal bone revealed pneumatised mastoid in
9(22.5%), diploic in 5(12.5%) and sclerosed mastoid in 26(65%)
cases.
Conclusion: The role of plain radiography is found to be limited
to know the type of mastoid pneumatisation. It can also as
Original Article
detect bony erosion in few cases. Because of the ability to see
temporal bone structures with great clarity, HRCT can be
recommended not only in cases suspected with potential
complications but also in all cases of temporal bone pathologies
to know the extent of disease, inter-relationships of the
tympanomastoid compartment with adjacent neurovascular
structures, varied pneumatisation and the presence of
anatomical variations, which should alert the clinician and
guide in surgical approach and treatment plan.
Localization of active otosclerotic foci by tympano-cochlear scintigraphy (TCS) using correlative imaging
