Our experience in rural population of south india doi. The aim of the present study was to evaluate the role of high resolution computed tomography hrct temporal bone in patients with active squamosal chronic otitis media com, by comparing the preoperative hrct temporal bone findings with the intra operative findings gold standard. The purpose of this study is to determine the role and efficacy of hrct temporal bone in evaluation of congenital, inflammatory, traumatic, and neoplastic conditions. Temporal bone complications are more common than intracranial complications. It shows normal temporal bone anatomy in four imaging planes. Pdf to master the detailed ct anatomy of the middle and inner ear to make use. Interactive webbased learning module on ct of the temporal. Pdf role of high resolution computed tomography of temporal. Role of high resolution computed tomography of temporal bone. In vivo measurements of temporal bone on reconstructed. The temporal bones were scanned in the direct axial and coronal planes using high resolution thin slices without contrast.
Several intrinsic channels, intrinsic fissures, and extrinsic sutures are often apparent on ct images and can mimic. In the first part, we explain how to image the temporal bone. Mr imaging can confirm the diagnosis because arachnoid granulations. Hrct temporal bone eliminates the main differentials and guides in management of osteomas by visualising tumour extension. Temporal bone fracture radiology reference article.
Lowdose pediatric hrct protocols are used to keep radiation doses to a minimum. Correlation of highresolution computed tomography temporal bone findings with intraoperative findings in patients with cholesteatoma sonika kanotra 1, rohan gupta 1, nitika gupta 1, rashmi sharma 2, saurabh gupta 2, sunil kotwal 1 1 department of ent and head and neck surgery, smgs hospital, government medical college, jammu, jammu and kashmir, india 2 department of radiodiagnosis and. The middle ear consists of the tympanic cavity and. High resolution multi detector computed tomography of temporal. Ct is the imaging modality of choice for most of the pathologic conditions of the temporal bone, especially for those of the middle ear. The role of hrct temporal bone comes in the knowing the extent of involvement caused by the disease. The temporal bone provides structural support for the skull, while protecting the cerebrum of the brain and surrounding membranes. Role of hrct and mri of the temporal bone in predicting. Planes of scanning axial 30 degrees to anthropological base line parallel to lateral scc. Hrct of the right temporal boneaxial section at the level of ossicles shows the long process of incus and stapes erosionblue arrow. Tumors of the temporal bone and skull base usually require a combination of ct and mr images. In addition, this bone surrounds the middle and inner portions of the ear. Due to its better spatial resolution, hrct is preferred in suspected intra temporal complications whereas mri is more useful in evaluating intracranial extension.
Most of this patients belonged to poor socioeconomic status who delayed the diagnosis and treatment due to one or the other reason there by leading to development of. Otosclerosis is categorised into two types, fenestral and retrofenestral. An evaluation of preoperative high resolution computed. Comparison of hrct findings with operative findings. They have a prevalence of 3% of all trauma patients in one series 6. Pdf anatomical characteristics of temporal bone on. Role of high resolution computed tomography of temporal bone in management of chronic suppurative otitis media. Petrous apex fractures tend to involve the iac and cochlea, explaining the higher prevalence of cn vii and viii dysfunction than with nonpetrous apex fractures fig. The temporal bone is one of the most important calvarial and skull base bones. High resolution computed tomography hrct, a modification of routine ct, provides a direct visual window in the temporal bone providing minute structural details.
The facial nerve canal turns abruptly at the geniculate fossa anterior genu. Hrct of the temporal bone has an excellent spatial resolution, thus even small softtissue lesions can be accurately. Each patient was subjected to full clinical evaluation and hrct temporal bone was done. The temporal bone contributes to the lower lateral walls of the skull. I created this video with the youtube video editor. The study was done on 50 patients diagnosed clinically with csom between december 2017 to may 2018 with the help of ge bright speed 16 slice machine. A glomus jugulare tumor grows in the temporal bone of the skull, in an area called the jugular foramen. One potential application of this technique is providing customized maps for. Temporal bone osteomyelitis is a serious lifethreatening conditiona quick and proper diagnosis is needed to start treatment and reduce morbidity and mortality. Analysis of anatomic variations in temporal bone by radiology. This gallery of images presents the anatomy of the temporal bone by means of ctscan reconstructions. Inflammation of the temporal bone neuroimaging clinics of north.
This study showed good correlation between preoperative hrct findings of cholesteatoma, and intraoperative. Only 9 patients out of 50 18% developed complications related to csom. High resolution computed tomography of the temporal bone. Congenital hearing deficits can be nongenetic or genetic in origin. Role of hrct and mri of the temporal bone in predicting and. An interactive webbased learning module on the temporal bone has been developed. Hrct of the temporal bone has an excellent spatial resolution, thus even small softtissue lesions can be.
Antrly the tensor tympani muscle is seen passing postrly in its canal, around the processus cochleariformis to reach the neck of the malleus. Clinically available reconstructed temporal bone hrct images in any plane of section can easily be retrospectively added to the standard axial and coronal hrct images of the temporal bone. Role of hrct temporal bone in preoperative evaluation of cholesteatoma. Methods this is a prospective crosssectional study to evaluate the role of hrct of temporal bone in 50 patients. Hrct temporal bone is useful to detect the extent of the disease, various complications, and guide the surgeon for preoperative planning. Computed tomography in temporal bone diseases and correlate hrct image based findings with the operative and pathological findings to.
It contains the middle and inner portions of the ear, and is crossed by the majority of the cranial nerves. Pathologic conditions involving the temporal bone in infants and children are now commonly diagnosed by computed tomography ct. Imaging for the pediatric population was performed under sedation or short acting general anesthesia. It is used in the diagnosis of various health problems, though most commonly for lung disease, by assessing the lung parenchyma. This technique obtains images with exquisite lung detail, which are ideal for the assessment of diffuse interstitial lung disease.
Role of high resolution computed tomography in evaluation of pathologies of temporal bone. Highresolution computed tomography study of temporal bone. Temporal bone fractures are subdivided into petrous apex and nonpetrous apex fractures. To emphasize the importance of a clinical suspicion of this dangerous condition, our experience with three difficult cases is presented. Correlation of highresolution computed tomography temporal. Pdf role of high resolution computed tomography of.
How to read a temporal bone ct temporal bone made ridiculously simple a systematic axial approach thank each one of you for making it happen. Evaluation of temporal bone cholesteatoma and the correlation. Hrct temporal bone is currently advocated in all cases suspected of cholesteatoma clinically prior to sur gery for assessment of the extent of disease, complica. Temporal bone is very difficult to access by clinical examination and normal radiograph.
This was the crosssectional prospective study of 11. Role of hrct temporal bone in patients with chronic. Role of high resolution computed tomography in evaluation. This prospective study was conducted at a tertiary referral teaching hospital and 40 cases of cholesteatoma were selected and their preoperative hrct temporal bone findings and intraoperative findings were correlated. High resolution ct imaging in pathologies of temporal bone. Two patients refused surgery tsmporal showed abnormal cochlea and other had semicircular canal malformations on hrct. Analysis of anatomic variations in temporal bone by. High resolution computed tomography of the temporal bone in. Clinical challenges in the diagnosis and treatment of. Osteoma of temporal bone over mastoid area is a very rare tumor. Highresolution computed tomography hrct is a type of computed tomography ct with specific techniques to enhance image resolution. Role of high resolution computed tomography hcrt in. Clinical study of correlation between preoperative findings of hrct with intraoperative findings of cholesteatoma in cases of csom.
Role of hrct in temporal bone diseases a study of 100 cases abstract high resolution computed tomogram h rct is a modality of routine computed tomogram. The temporal bone is situated on the sides and the base of the cranium and lateral to the temporal lobe of the cerebrum. Otosclerosis is an otodystrophy of the otic capsule and is a cause of conductive, mixed or sensorineural hearing loss in the 2nd to 4th decades of life. A glomus jugulare tumor is a tumor of the part of the temporal bone in the skull that involves the middle and inner ear structures. Plain hrct temporal bone was done using 64 slice multidetector ct scan with axial, coronal and sagittal reconstruction in high bony algorithm and whenever required soft tissue window settings. Congenital malformations developmental malformations that affect the eac and middle ear may cause conductive hearing loss, whereas those that affect the membranous and bony labyrinth may result in sensorineural hearing loss snhl. Nov 02, 2016 this feature is not available right now.
Introduction to ct interpetation of temporal bone fractures duration. A fracture line arrow traverses the temporal bone obliquely, with features of both transverse and longitudinal type fractures. This is a prospective crosssectional study to evaluate the role of hrct of temporal bone in 50 patients clinically diagnosed with csom and referred to the department of radiodiagnosis and imaging, pes institute of medical sciences, kuppam for hrct scan of temporal bone between october 20 to september 2015. The lower portion of the bone articulates with the mandible, forming the temporomandibular joint of the jaw. Treatment is surgical and must be considered according to the cosmetic deformity and the symptoms. Imaging plays an important role in the diagnosis and management of otosclerosis. This tumor can affect the ear, upper neck, base of the skull, and the surrounding blood vessels and nerves. Neuroradiology of cholesteatomas american journal of. Highresolution ct hrct of the chest, also referred to as hrct chest or hrct of the lungs, refers to a ct technique in which thinslice chest images are obtained and postprocessed in a highspatialfrequency reconstruction algorithm.
Highresolution ct hrct of the temporal bone using 1mm or less thick sections is. High resolution computed tomography provides exquisite details of the bony land marks within the temporal bone and has added a whole new dimension to evaluation of the temporal bone by allowing the visualization the soft tissue components within and adjacent to the temporal bone. Purpose of the present study was to evaluate the normal variations, pathological processes. On the right, the external auditory canal, mastoid complexes, and middle ear, including the ossicles and pneumatization are normal.
All patients in the study were evaluated by hrct and mri of the temporal bone. Highresolution computed tomography hrct is ideally suited. Due to its excellent spatial resolution, hrct is invaluable in assessment of chronically discharging ears, especially to look for bone erosion and the integrity of the ossicles. Highresolution computed tomography hrct is the modality of. Role of high resolution computed tomography of temporal. Temporal bone ct and mri anatomy by jan kopriva and jan zizka is a compre hensive atlas of radiological anatomy of the temporal bone. Changing trends of the disease make a differential diagnosis difficult. The temporal bone is very complex and consists of five parts 1,2 squamous part. Some structures are discussed in more detail with emphasis on related pathology.
Each temporal bone is composed of five osseous parts. The anatomical complexity of the temporal bone represents. Arachnoid granulations are rarely seen on highresolution ct hrct at the posterior temporal bone wall, where they appear as erosions, without bone spicules and often with a lobulated surface. Differential diagnosis includes endolymphatic sac tumor, paraganglioma, chordoma, and chondromatous and metastatic tumors. Pdf basic and advanced temporal bone anatomy using different. Sections parallel to the hard palate direct coronal plane patient head extended in prone or supine with 105 degree plane is perpendicular to the lateral scc sections are parallel to posterior wall of maxillary sinus. Role of high resolution computed tomography in evaluation of. Hrct findings were compared with operative features. The indications and limitations of ct and mr imaging and the use of novel mr imaging techniques in the diagnosis of cholesteatomas are described. Arachnoid granulations of the posterior temporal bone wall.
A prospective study of 104 clinically diagnosed patients with com were included. All important anatomi cal structures of the temporal. In this image the labyrinthine segment cn7 canal terminates in geniculate fossa. The role of catheter angiography is limited to the evaluation of pulsatile tinnitus when crosssectional imaging has failed to reveal a cause and in the preoperative evaluation and. Is hrct temporal bone necessary in all cases of active. Discussion hrct plays an important role in the radiographic assessment of temporal bone and is helpful in diagnosis and treatment of temporal bone diseases. Highresolution computed tomography study of temporal. In temporal bone it precisely delineates the bony structures as well as the soft tissue component.
One potential application of this technique is providing customized maps for presurgical planning and illustrating pathologies. Temporal bone ct mr imaging ear inflammation otitis diffusion weighted. Hrct of the temporal bones can provide crucial information regarding the anatomy of the temporal bone and the extent of disease which is not visible on clinical examination alone. Hrct temporal bone accurately depicts bony erosion or destruction and associated soft tissue pathology. Temporal bone fracture is suggested by battle sign postauricular ecchymosis and bleeding from the external auditory canal. Its lower portion connects with the mandible or jawbone to allow the mouth to open and close. The temporal bones comprise the lateral skull base, forming portions of the middle and posterior fossae.