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

Author(s):  
Prakash S. Handi ◽  
Mallikarjun N. Patil ◽  
Nisha P.

<p class="abstract"><strong>Background:</strong> <span lang="EN-IN">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. </span></p><p class="abstract"><strong>Methods:</strong> <span lang="EN-IN">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 (%).  </span></p><p class="abstract"><strong>Results:</strong> <span lang="EN-IN">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. </span></p><p class="abstract"><strong>Conclusions:</strong> <span lang="EN-IN">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.</span></p>

2006 ◽  
Vol 18 (05) ◽  
pp. 214-221 ◽  
Author(s):  
CHIA-FONE LEE ◽  
PEIR-RONG CHEN ◽  
WEN-JENG LEE ◽  
JYH-HORNG CHEN ◽  
TIEN-CHEN LIU

In order to present a systematic and practical approach that uses high-resolution computed tomography (HRCT) to derive models of the middle ear for finite element analysis (FEA). This prospective study included 31 subjects with normal hearing and no previous otological disorders. Temporal bone images obtained from 15 right ears and 16 left ears were used for evaluation and reconstruction. High-resolution computed tomography of temporal bone was performed using simultaneous acquisition of 16 sections with a collimated slice thickness of 0.625 mm. All images were transferred to an Amira visualization system for 3D reconstruction. The created 3-D model was translated into two commercial modeling packages, Patran and ANSYS, for finite element analysis. The characteristic dimensions of the model were measured and compared with previous published histological section data. This result confirms that the geometric model created by the proposed method is accurate except the tympanic membrane is thicker than that of histological section method. No obvious difference in the geometrical dimension between right and left ossicles was found (p > 0.05). The 3D model created by finite element method and predicted umbo and stapes displacements are close to the bounds of the experimental curves of Nishihara's, Huber's, and Gan's data across the frequency range of 100-8000 Hz. The model includes a description of the geometry of the middle ear components, and dynamic equations of vibration. The proposed method is quick, practical, low cost and most importantly, non-invasive as compared with histological section methods.


Author(s):  
Jaiprakash Tak ◽  
Ajeet Kumar Khilnani

<p class="abstract"><strong>Background:</strong> High Resolution Computed Tomography (HRCT) has widely replaced conventional techniques (X-Ray Mastoid bone) for temporal bone imaging. The most significant use of computed tomography lies in evaluation of cases of Chronic Suppurative Otitis Media (CSOM). The objective of the study was to evaluate the usefulness of HRCT scanning of temporal bone in defining the extent and severity of disease in patients with CSOM, thereby altering the surgical plan and outcome.</p><p class="abstract"><strong>Methods:</strong> This prospective study was conducted at a tertiary care hospital in Ahmedabad. After obtaining approval from IEC (Institutional Ethical Committee), study was carried out on 50 patients diagnosed with CSOM of attico-antral type. Written informed consent of all patients was taken before enrollment in the study. HRCT scan findings were reviewed and correlated with per-operative findings.</p><p class="abstract"><strong>Results:</strong> Out of total 50 patients of CSOM, 26 (52%) were males. Majority of the patients (70%) were in the age group of 11 to 30 years. Left ear was involved in 40% of the patients. Majority of the patients (80%) presented with chief complaint of otorrhoea. In the present study, External Auditory Canal (EAC) was seen normal in majority of patients (82%) both radio logically and per operatively. HRCT scan was found to be very sensitive (96%) in diagnosing cholesteatoma. The sensitivity of HRCT for diagnosing disease in epitympanum, antrum and aditus was found to be 100%, 97% and 88% respectively. CT scans diagnosed erosion of malleus with 100% sensitivity and specificity and erosion of incus with 91% sensitivity and 100% specificity.</p><p><strong>Conclusions:</strong> HRCT was helpful in determining the anatomy of the middle ear and mastoid, and accurately predicted the extent of the disease process of CSOM. </p>


2019 ◽  
Vol 6 (2) ◽  
pp. 449
Author(s):  
Ponnam Bharath Kumar ◽  
Kiran Mai ◽  
Santosh Karpur

Background: Prior to surgery it is very important that the surgeon is fully aware, and he should have the clear picture as to the extent of the disease and the nature of the disease to give satisfactory surgical outcomes for the patient. HRCT (High resolution computed tomography) is one such guiding tool for the surgeon. The objective was to study usefulness of HRCT scan in attico-antral disease in depicting the status of the middle ear structures.Methods: A total of 30 patients were studied.  HRCT temporal bone was performed by using SIEMENS EMOTION 16 slice CT machine in axial plane and coronal images were reformatted. Findings of HRCT temporal bone were recorded.  Findings of mastoid exploration surgery were recorded. Report of HRCT of temporal bone was correlated with surgical findings and tabulated using percentages.Results: Surgery showed cholesteatoma in 26 (86.6%) patients. Epitympanum was involved in 29 (96.6%) patients in HRCT and 30 (100%) patients at surgery. Extension beyond middle ear cleft was seen in 4 (13.3%) patients in HRCT and 5 (16.6%) patients at surgery. Tympanic segment of facial canal was the most commonly involved, showing erosion in 10 (33.3%) patients in HRCT and 12 (40%) patients at surgery. Lateral SCC was the most commonly involved in bony labyrinth seen in 4 (13.3%) patients in both HRCT and surgery. Erosion of dural plate was seen in 6 (20%) patients in HRCT whereas 9 (30%) patients showed dural plate erosion at surgery.Conclusions: HRCT of temporal bone plays a promising role in pre-operative assessment of cholesteatoma as it depicts the extent of the disease and integrity of most of the middle ear structures.


2021 ◽  
Vol 8 (32) ◽  
pp. 2968-2973
Author(s):  
Lilly Boney ◽  
Manasa Pandith

BACKGROUND The tympanic cavity is susceptible to infection by viruses and bacteria through the Eustachian tube, thereby making ear pathologies and particularly middle ear inflammatory conditions a frequent reason to consult an otorhinolaryngologist. With the advent of High-Resolution Computed Tomography, diagnosis of the middle ear anatomy, pathology and its complications if any, could be made out with better precision by providing a direct visual window by providing minute structural details. The aim of the study was to assess temporal bone pathologies that could be evaluated by HRCT study of the temporal bone in a rural hospital based setup and correlate if possible with surgical/histopathological findings. METHODS The study was a retrospective study done in M.V.J Medical College and Research Hospital, Bangalore amongst 50 patients from February 2020 to January 2021 who underwent HRCT of the temporal bone and relevant statistics were drawn from these cases. After local examination, clinical evaluation and consent, CT scan was performed. Follow-up of patients was done for confirmation with operative and/or histopathological findings whenever possible. All the data obtained were recorded in a tabulated form and analysed on MS Excel. RESULTS Amongst 50 patients, infective aetiology was found to be the most common cause, of which chronic otomastoiditis was the most common, followed by chronic Cholesteatoma, otitis media, chronic mastoiditis, and otitis externa. Amongst the congenital aetiology, we had 1 case each of osteoma, facial nerve involvement, microtia and inner ear dysplasia. Amongst the traumatic cases, longitudinal type of fracture was the most common type, followed by transverse and mixed fractures with hemotympanum being the most common HRCT finding. CONCLUSIONS HRCT of the temporal bone helps in accurate assessment of infective, congenital, traumatic and neoplastic aetiologies and helps the otologist understand the disease's extent and aid in surgery. KEYWORDS High-Resolution Computed Tomography, HRCT, Temporal bone, Radiology


2013 ◽  
Vol 6 ◽  
pp. CMENT.S10681 ◽  
Author(s):  
Mohammed A. Gomaa ◽  
Abdel Rahim A. Abdel Karim ◽  
Hosny S. Abdel Ghany ◽  
Ahmed A. Elhiny ◽  
Ahmed A. Sadek

Background Acquired cholesteatomas are commonly seen in patients less than 30 years. There is a typical history of recurrent middle ear infections with tympanic membrane perforation. The diagnosis of cholesteatoma is usually made on otologic examination. Objective The aim of the work was to study the role of high resolution computed tomography (HRCT) in detecting, evaluating, and diagnosing middle ear cholesteatoma. Patients and methods This was a prospective study that included 56 consecutive patients with chronic suppurative otitis media, unsafe type cholesteatomas. Each patient was subjected to full clinical evaluation, and HRCT examination. Intravenous contrast media was used in some patients with suspected intracranial complication. Preoperative radiological data were correlated with data related to surgical findings. Results The study showed that a high incidence of cholesteatoma in the third decade of life. The scutum and lateral attic wall were the most common bony erosions in the middle ear bony wall (64.3%), and the incus was the most eroded ossicle in the middle ear (88.2%). Sclerosing of mastoid air cells were encountered in 60.7% of patients and the lateral semicircular canal was affected in 9%, while facial canal erosion was found in 21.4%. Temporal bone complications are more common than intracranial complications. HRCT findings were compared with operative features; the comparative study included the accuracy and sensitivity of HRCT in detecting cholesteatoma (92.8%), its location and extension (96.4%), ossicular chain erosion (98%), labyrinthine fistula and intracranial complications (100%). Conclusion The important role of HRCT scannig lies on the early detection of cholesteatoma, and more conservative surgical procedures can be used to eradicate the disease.


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