The facial nerve canal turns abruptly at the geniculate fossa anterior genu. Computed tomography in temporal bone diseases and correlate hrct image based findings with the operative and pathological findings to. Neuroradiology of cholesteatomas american journal of. Pdf to master the detailed ct anatomy of the middle and inner ear to make use. In temporal bone it precisely delineates the bony structures as well as the soft tissue component. Highresolution computed tomography hrct is the modality of.
Our experience in rural population of south india doi. Pdf anatomical characteristics of temporal bone on. Purpose of the present study was to evaluate the normal variations, pathological processes. It shows normal temporal bone anatomy in four imaging planes. Introduction to ct interpetation of temporal bone fractures duration. This tumor can affect the ear, upper neck, base of the skull, and the surrounding blood vessels and nerves. Each patient was subjected to full clinical evaluation and hrct temporal bone was done. High resolution computed tomography of the temporal bone in. Temporal bone complications are more common than intracranial complications. This study showed good correlation between preoperative hrct findings of cholesteatoma, and intraoperative. Two patients refused surgery tsmporal showed abnormal cochlea and other had semicircular canal malformations on hrct. High resolution computed tomography hrct, a modification of routine ct, provides a direct visual window in the temporal bone providing minute structural details. Hrct temporal bone eliminates the main differentials and guides in management of osteomas by visualising tumour extension.
The temporal bone provides structural support for the skull, while protecting the cerebrum of the brain and surrounding membranes. Temporal bone fracture radiology reference article. 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. Role of hrct and mri of the temporal bone in predicting and. 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. This was the crosssectional prospective study of 11.
Hrct of the temporal bone has an excellent spatial resolution, thus even small softtissue lesions can be. This technique obtains images with exquisite lung detail, which are ideal for the assessment of diffuse interstitial lung disease. 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. Treatment is surgical and must be considered according to the cosmetic deformity and the symptoms. It contains the middle and inner portions of the ear, and is crossed by the majority of the cranial nerves. Role of high resolution computed tomography in evaluation of pathologies of temporal bone. Imaging for the pediatric population was performed under sedation or short acting general anesthesia.
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. 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. Arachnoid granulations of the posterior temporal bone wall. In addition, this bone surrounds the middle and inner portions of the ear. Antrly the tensor tympani muscle is seen passing postrly in its canal, around the processus cochleariformis to reach the neck of the malleus.
Hrct temporal bone accurately depicts bony erosion or destruction and associated soft tissue pathology. Temporal bone ct and mri anatomy by jan kopriva and jan zizka is a compre hensive atlas of radiological anatomy of the temporal bone. The temporal bone is very complex and consists of five parts 1,2 squamous part. Inflammation of the temporal bone neuroimaging clinics of north. Lowdose pediatric hrct protocols are used to keep radiation doses to a minimum. Nov 02, 2016 this feature is not available right now.
To assess the usefulness of high resolution computed tomography hrct temporal bones in cases of active squamous chronic otitis media com. Changing trends of the disease make a differential diagnosis difficult. 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. Discussion hrct plays an important role in the radiographic assessment of temporal bone and is helpful in diagnosis and treatment of temporal bone diseases. 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. 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. Role of high resolution computed tomography in evaluation. Clinical study of correlation between preoperative findings of hrct with intraoperative findings of cholesteatoma in cases of csom. One potential application of this technique is providing customized maps for presurgical planning and illustrating pathologies. Pdf role of high resolution computed tomography of. I created this video with the youtube video editor. Analysis of anatomic variations in temporal bone by. The importance of utilizing high resolution computed tomography hrct with magnified, thin 1. 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.
Imaging plays an important role in the diagnosis and management of otosclerosis. The aim of this presentation is to demonstrate imaging findings of common diseases of the temporal bone. Osteoma of temporal bone over mastoid area is a very rare tumor. Each temporal bone is composed of five osseous parts. Role of high resolution computed tomography of temporal bone in management of chronic suppurative otitis media. Interactive webbased learning module on ct of the temporal. 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. Pdf role of high resolution computed tomography of temporal. Tumors of the temporal bone and skull base usually require a combination of ct and mr images. The role of hrct temporal bone comes in the knowing the extent of involvement caused by the disease. Temporal bone ct mr imaging ear inflammation otitis diffusion weighted. Several intrinsic channels, intrinsic fissures, and extrinsic sutures are often apparent on ct images and can mimic. This gallery of images presents the anatomy of the temporal bone by means of ctscan reconstructions. Hrct temporal bone is useful to detect the extent of the disease, various complications, and guide the surgeon for preoperative planning.
The anatomical complexity of the temporal bone represents. The temporal bone is situated on the sides and the base of the cranium and lateral to the temporal lobe of the cerebrum. In this image the labyrinthine segment cn7 canal terminates in geniculate fossa. Evaluation of temporal bone cholesteatoma and the correlation. May 05, 2015 all patients in the study were evaluated by hrct and mri of the temporal bone. Axial thinsection ct image of the temporal bone in a motor vehicle accident victim and complex hearing loss.
Ct is the imaging modality of choice for most of the pathologic conditions of the temporal bone, especially for those of the middle ear. Highresolution computed tomography study of temporal bone. On the right, the external auditory canal, mastoid complexes, and middle ear, including the ossicles and pneumatization are normal. Only 9 patients out of 50 18% developed complications related to csom. 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. Temporal bone fracture is thought to occur in 20% range 1422% of all calvarial fractures. Extent of temporal bone injuries and inflammatory conditions were clearly delineated in all cases. Role of hrct and mri of the temporal bone in predicting. Mr imaging can confirm the diagnosis because arachnoid granulations. Role of high resolution computed tomography hcrt in.
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. Hrct of the temporal bone has an excellent spatial resolution, thus even small softtissue lesions can be accurately. 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. In the first part, we explain how to image the temporal bone. High resolution ct imaging in pathologies of temporal bone. 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. Role of hrct in temporal bone diseases a study of 100 cases. One potential application of this technique is providing customized maps for. An evaluation of preoperative high resolution computed. All patients in the study were evaluated by hrct and mri of the temporal bone. Pathologic conditions involving the temporal bone in infants and children are now commonly diagnosed by computed tomography ct. Highresolution computed tomography hrct is ideally suited. High resolution computed tomography of the temporal bone. Role of hrct temporal bone in patients with chronic.
Highresolution computed tomography study of temporal. The lower portion of the bone articulates with the mandible, forming the temporomandibular joint of the jaw. Hrct of the right temporal boneaxial section at the level of ossicles shows the long process of incus and stapes erosionblue arrow. To emphasize the importance of a clinical suspicion of this dangerous condition, our experience with three difficult cases is presented. They have a prevalence of 3% of all trauma patients in one series 6. Correlation of highresolution computed tomography temporal.
A fracture line arrow traverses the temporal bone obliquely, with features of both transverse and longitudinal type fractures. Congenital hearing deficits can be nongenetic or genetic in origin. In vivo measurements of temporal bone on reconstructed. Comparison of hrct findings with operative findings. Role of high resolution computed tomography in evaluation of. All important anatomi cal structures of the temporal. Some structures are discussed in more detail with emphasis on related pathology.
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. Methods this is a prospective crosssectional study to evaluate the role of hrct of temporal bone in 50 patients. Analysis of anatomic variations in temporal bone by radiology. Temporal bone is very difficult to access by clinical examination and normal radiograph. Its lower portion connects with the mandible or jawbone to allow the mouth to open and close. Highresolution ct hrct of the temporal bone using 1mm or less thick sections is.
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. A prospective study of 104 clinically diagnosed patients with com were included. Hrct findings were compared with operative features. Pdf basic and advanced temporal bone anatomy using different. 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 temporal bones comprise the lateral skull base, forming portions of the middle and posterior fossae. Temporal bone osteomyelitis is a serious lifethreatening conditiona quick and proper diagnosis is needed to start treatment and reduce morbidity and mortality. Due to its better spatial resolution, hrct is preferred in suspected intra temporal complications whereas mri is more useful in evaluating intracranial extension. It is hoped that this article may facilitate other units overcoming obstacles to establish a temporal bone laboratory. High resolution multi detector computed tomography of temporal. 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. Otosclerosis is categorised into two types, fenestral and retrofenestral. This chapter on the technique for imaging the temporal bone is a practical how to written in two parts.
The temporal bone contributes to the lower lateral walls of the skull. 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. A glomus jugulare tumor grows in the temporal bone of the skull, in an area called the jugular foramen. The middle ear consists of the tympanic cavity and. 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.
Is hrct temporal bone necessary in all cases of active. Temporal bone fractures are subdivided into petrous apex and nonpetrous apex fractures. Differential diagnosis includes endolymphatic sac tumor, paraganglioma, chordoma, and chondromatous and metastatic tumors. 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. It is used in the diagnosis of various health problems, though most commonly for lung disease, by assessing the lung parenchyma. The temporal bones were scanned in the direct axial and coronal planes using high resolution thin slices without contrast. Planes of scanning axial 30 degrees to anthropological base line parallel to lateral scc. An interactive webbased learning module on the temporal bone has been developed. The temporal bone is one of the most important calvarial and skull base bones. Role of hrct temporal bone in preoperative evaluation of cholesteatoma. May 27, 2015 imaging of temporal bone pathology 94. Highresolution computed tomography hrct is a type of computed tomography ct with specific techniques to enhance image resolution.
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. The indications and limitations of ct and mr imaging and the use of novel mr imaging techniques in the diagnosis of cholesteatomas are described. Role of high resolution computed tomography of temporal. 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.
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