scholarly journals Diagnostic efficacy of high-resolution computed tomography findings in patients of chronic suppurative otitis media atticoantral type

2020 ◽  
Vol 6 (10) ◽  
pp. 1854
Author(s):  
Nikki Gajjar ◽  
Neena Bhalodiya ◽  
Simple Bhadania
Keyword(s):  
Soft Tissue ◽  
Temporal Bone ◽  
Facial Canal ◽  
Soft Tissue Density ◽  
High Resolution Computed Tomography ◽  
Suppurative Otitis Media ◽  
Tissue Density ◽  
Facial Canal Dehiscence ◽  
Operative Findings ◽  
Canal Dehiscence

<p><strong>Background: </strong>High resolution computed tomography (HRCT) provides information about anatomy and pathology of temporal bone and middle ear cleft, thus becoming important imaging modality in diagnosis and pre-operative planning in patients of chronic suppurative otitis media (attico-antral) CSOM (AA) type. The aim of study was to study disease extension and plan surgery accordingly in patients of CSOM (AA) and to study correlation between the HRCT findings and intra-operative findings of CSOM (AA) like soft tissue density mass, ossicular chain erosion, facial canal dehiscence, semi-circular canal erosion.</p><p><strong>Methods: </strong>Study of 70 patients clinically diagnosed of having CSOM (AA) in period between August 2018 to March 2020 was done at Sola civil hospital, Ahmedabad. All patients were advised HRCT temporal bone except those who had contraindications to CT scan, analysed and operated. Pre-operative CT-scan findings and intra-operative findings were compared for statistical analysis.</p><p><strong>Results: </strong>Soft tissue density was found in 100% of cases on HRCT temporal bone. Bony erosion seen in 25% of cases. 90% showed ossicular erosion. Lateral semi-circular canal fistula was observed in 10% of cases with facial canal dehiscence in 10% of cases. Intra-operative findings showed accuracy of HRCT in detecting soft tissue density to be 100%; bony erosion was observed in 25% cases. 10% patients had lateral semi-circular canal fistula. Facial canal dehiscence was seen in 15% cases.</p><strong>Conclusion: </strong>HRCT has proved quite useful and reliable to identify the disease extension before surgery and plan surgery accordingly.<p> </p>

scholarly journals Paediatric acquired cholesteatoma, our experience in a tertiary care: two year prospective study

2020 ◽  
Vol 6 (11) ◽  
pp. 1960
Author(s):  
Akshay Jain ◽  
Smruti Milan Tripathi ◽  
Poonji Gupta
Keyword(s):  
Soft Tissue ◽  
Facial Nerve ◽  
Temporal Bone ◽  
Middle Ear ◽  
Age Group ◽  
Soft Tissue Density ◽  
Nerve Paralysis ◽  
Tissue Density ◽  
Acquired Cholesteatoma ◽  
Canal Dehiscence

<p><strong>Background:</strong> Aim of the study was to estimate the benefits of having high-resolution computed tomography (HRCT) of temporal bone on clinically evaluated paediatric patients of acquired cholesteatoma.</p><p><strong>Methods:</strong> A total of 60 patients of paediatric age group (2-18 years) who were diagnosed with active squamosal type of chronic otitis media were selected for the study. HRCT of temporal bone was done in all the patients and findings were recorded.</p><p><strong>Results:</strong> Most patients were in the age group of 11-15 years (46.6%). Findings of pars tensa were subtotal perforation in 2 patients (3.3%), small central perforation in 8 patients (13.3%) and postero-superior marginal perforation in 12 patients (20%). Pars flaccida retraction pocket with cholesteatoma was seen in 31 patients (51.6%) and perforation with cholesteatoma in 13 patients (21.6%). Scutum erosion was seen in 31 patients (51.6%), ossicular erosion in 12 patients (20%) and facial nerve paralysis in 2 patients (3.3%). On HRCT temporal bone we found soft tissue density in middle ear in 60 patients (100%), soft tissue density in mastoid in 53patients (88.3%), osscicular erosion in 54 patients (90%), scutum erosion in 46 patients (76.6%), facial nerve canal dehiscence in 5 patients (8.3%), semicircular canal dehiscence in 2 patients (3.3%) and dural plate dehiscence in 11 patients (18.3%).</p><p><strong>Conclusions:</strong> HRCT of temporal bone is helpful in depicting a clearer picture of middle ear cavity structures involved by cholesteatoma and thus helpful in formulating a strategy for further management.</p>

Is there a relationship between mastoid pneumatisation and facial canal dimensions?

2019 ◽  
Vol 133 (7) ◽  
pp. 546-553
Author(s):  
M Inal ◽  
N Bayar Muluk ◽  
N Asal ◽  
M H Şahan ◽  
G Şimşek ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Retrospective Study ◽  
Multidetector Computed Tomography ◽  
Temporal Bone ◽  
Facial Canal ◽  
Computed Tomography Scans ◽  
Facial Canal Dehiscence ◽  
Older Subjects ◽  
The Right ◽  
Canal Dehiscence

AbstractObjectiveTo evaluate mastoid pneumatisation and facial canal dimensions.MethodIn this retrospective study, 169 multidetector computed tomography scans of temporal bone were reviewed. Facial canal dimensions were evaluated at the labyrinthine, tympanic and mastoid segments using axial and coronal multidetector computed tomography scans of temporal bone. Mastoid pneumatisation and facial canal dehiscence were evaluated. Facial canal dehiscence was measured if it was found to be present.ResultsThis study showed that facial canal dimensions decreased in pneumatised mastoids. Facial canal dimensions in females were smaller than in males. Facial canal dehiscence was detected in 5.9 per cent and 6.5 per cent of the patients on the right and left sides, respectively. No correlations were found between facial canal dehiscence and mastoid pneumatisation. The length of dehiscence was 1.92 ± 0.44 mm (range, 0.86–2.51 mm) on the left side. In older subjects, left facial canal dehiscence was detected more, and the length of the dehiscence increased.ConclusionThis study concluded that during surgery, facial canal dehiscence should be kept in mind in order to avoid complications.

scholarly journals Imaging features of hemangioma in long tubular bones

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Lei Cao ◽  
Jin-Xu Wen ◽  
Shu-Man Han ◽  
Hui-Zhao Wu ◽  
Zhi-Gang Peng ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Plain Radiograph ◽  
Ground Glass Opacity ◽  
Plain Radiography ◽  
Long Bone ◽  
Imaging Features ◽  
Mri Imaging ◽  
Soft Tissue Density ◽  
Tissue Density ◽  
Hyperintense Signal

Abstract Background To investigate the imaging features of hemangiomas in long tabular bones for better diagnosis. Methods Twenty-four patients with long bone hemangiomas confirmed by pathology were enrolled. Nineteen patients had plain radiography, fourteen patients had computed tomography (CT) and eleven had magnetic resonance imaging (MRI). The hemangioma was divided into medullary [13], periosteal [6] and intracortical type [5]. Results Among 19 patients with plain radiography, eleven patients were medullary, three periosteal, and five intracortical. In the medullary type, the lesion was primarily osteolytic, including five cases with irregular and unclear rims and one lesion having osteosclerotic and unclear rims. In three patients with the periosteal type, the lesion had clear rims with involvement of the cortical bone in the form of bone defect, including two cases with local thickened bone periosteum and one case having expansile periosteum. Five intracortical hemangiomas had intracortical osteolytic lesions with clear margins. Among 14 patients with CT imaging, 8 cases were medullary, three periosteal, and three intracortical. Among 8 medullary hemangiomas, one had ground glass opacity, and seven had osteolytic, expansile lesions like soft tissue density with no calcification. In three periosteal cases, the lesion was osteolytic with thickened periosteum and narrowed medullary cavity. In three intracortical hemangiomas, the lesion was of even soft tissue density with no calcification. Among 11 patients with MRI imaging, seven were medullary, two periosteal, and two intracortical. Among 7 medullary lesions, six were of hypointense signal on T1WI and hyperintensesignal on T2 WI. In two periosteal cases, the periosteum was thickened, with one case being of equal signal, and the other having no signal. Two intracortical hemangiomas were both of slightly low signal on T1WI but hyperintense signal on T2WI. Conclusions The long bone hemangiomas had characteristic cystic honeycomb-like presentations in plain radiograph. CT and MRI imagings are helpful for diagnosis of hemangiomas in long bone.

scholarly journals Can MDCT Scan of the Temporal Bone Looking at Pneumatization Predict Surgical Vulnerability of the Facial Nerve?

2019 ◽  
pp. 014556131987952
Author(s):  
Mikail Inal ◽  
Nuray Bayar Muluk ◽  
Mehmet Hamdi Şahan ◽  
Neşe Asal ◽  
Gökçe Şimşek ◽  
...  
Keyword(s):  
Facial Nerve ◽  
Facial Canal ◽  
Nerve Injuries ◽  
Mastoid Pneumatization ◽  
Computed Tomography Scans ◽  
Facial Nerve Injuries ◽  
Important Landmark ◽  
Facial Canal Dehiscence ◽  
Males And Females ◽  
Canal Dehiscence

Objectives: The aim of this study is to investigate the scutum–cochleariform process (CP) and scutum–promontorium distances according to the mastoid pneumatization condition. Methods: Two hundred temporal multidetector computed tomography scans (90 males and 110 females) were evaluated retrospectively. The scutum-CP and scutum–promontorium distances were measured. Facial canal dehiscence (FCD) in the tympanic segment and mastoid pneumatization were also evaluated. Results: The distances between scutum-CP and scutum–promontorium were not different between males and females and between right and left sides. Facial canal dehiscence in the tympanic segment was detected: 5.6% (right) and 7.8% (left) in males and 5.5% (right) and 10.0% (left) in females. Grade 4 (100%) pneumatization was detected mainly in 55.6% to 57.8% of the patients in both genders. Grade 0 (0%) pneumatization (sclerosis) was detected in 22.2% to 28.2% of both males and females. In more pneumatized mastoids, the scutum-CP and scutum–promontorium distances increased. In sclerotic mastoids, the scutum-CP and scutum–promontorium distances decreased. Facial canal dehiscence rates were not related to the mastoid pneumatization levels. Conclusion: Cochleariform process is an important landmark to localize the tympanic segment of the facial canal. In sclerosed mastoids, scutum-CP and scutum–promontorium distances decreased. There was no relationship between FCD rates and mastoid pneumatization levels. It may be due to the development of FCD that occurs during the intrauterine period. In endoscopic and classic ear surgeries, mastoid pneumatization must be evaluated preoperatively to avoid facial nerve injuries.

Fungal rhinosinusitis

2000 ◽  
Vol 114 (1) ◽  
pp. 76-80 ◽  
Author(s):  
V. J. Lund ◽  
G. Lloyd ◽  
L. Savy ◽  
D. Howard
Keyword(s):  
Soft Tissue ◽  
Fungal Infections ◽  
Bone Erosion ◽  
Imaging Modality ◽  
Diagnostic Specificity ◽  
Soft Tissue Density ◽  
Tissue Density ◽  
Non Invasive ◽  
Fungal Rhinosinusitis ◽  
Scanning Technique

Fungal infections in both their invasive and non-invasive forms can prove difficult to diagnose. The often characteristic appearances on imaging are of great assistance. CT is the primary imaging modality and is probably more accurate than MRI in diagnostic specificity and determining the extent of bone erosion. However this may require a modified scanning technique to adequately demonstrate the typical soft tissue density variations of fungi. MRI should be used to supplement CT when intra-cranial or intra-orbital extension is suspected.

“Aggressive” Renal Angiomyolipoma

1996 ◽  
Vol 37 (3P2) ◽  
pp. 927-932 ◽  
Author(s):  
G. Cittadini ◽  
F. Pozzi Mucelli ◽  
F. M. Danza ◽  
L. E. Derchi ◽  
R. S. Pozzi Mucelli
Keyword(s):  
Soft Tissue ◽  
Lymph Nodes ◽  
Venous Thrombosis ◽  
Fatty Infiltration ◽  
Vena Cava ◽  
Renal Angiomyolipoma ◽  
Soft Tissue Density ◽  
Tissue Density ◽  
Associated Lesions ◽  
Renal Hilum

Purpose: We describe the US and CT examinations of 4 patients with renal angiomyolipoma with an “aggressive” appearance, and review the literature. Material and Methods: The imaging findings in 4 patients with benign renal angiomyolipomas associated with thrombosis of the renal vein and/or inferior vena cava are presented. In one case, enlarged lymph nodes at the renal hilum were found. Results: CT demonstrated fat densities within both tumor and thrombus. In one patient, small lymph nodes with low density internal areas were detected in the para-aortic region. When considering our patients together with those reported in the literature, we found that most angiomyolipomas with venous invasion were large and centrally located within the kidney. Venous thrombosis was observed in 9 lesions of the right kidney, and in only 4 of the left one; detection of the site of origin was impossible in one case. One patient only had symptoms due to the thrombus; 10 had problems due to the tumor; and 3 were asymptomatic. Only 4 patients with pararenal enlarged lymph nodes have been reported on in the imaging literature. Fat-containing nodes were detected by CT in one case only; the others had enlarged nodes of soft-tissue density. In one patient the diagnosis of hamartomatous lymph node invasion was established by angiography. Conclusion: In patients with renal angiomyolipoma, demonstration of both fatty thrombus and the fatty infiltration of lymph nodes of the renal hilum cannot be regarded as an indication of malignancy, but only of local aggressive behavior. Although surgery is commonly contemplated to prevent symptoms from venous thrombosis, conservative treatment seems possible. Detection of enlarged lymph nodes of soft tissue density may cause difficult diagnostic problems, with the diagnosis addressed only by the presence of associated lesions. Increased awareness that renal angiomyolipoma can sometimes appear “aggressive” could help to prevent such lesions from being considered malignant, and thus avoid surgical confirmation of their nature.

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