Back to the list
Congress: ECR24
Poster Number: C-13011
Type: EPOS Radiologist (educational)
DOI: 10.26044/ecr2024/C-13011
Authorblock: S. E. Chiriac, N. Guinand, P. Senn, M. Becker; Geneva/CH
Disclosures:
Simina Elena Chiriac: Nothing to disclose
Nils Guinand: Nothing to disclose
Pascal Senn: Nothing to disclose
Minerva Becker: Nothing to disclose
Keywords: Ear / Nose / Throat, Head and neck, Cone beam CT, Image manipulation / Reconstruction, Complications, Surgery, Treatment effects, Developmental disease, Prostheses, Tissue characterisation
Learning objectives To review the normal middle ear anatomy and frequently encountered pathology after tympanoplasty and ossicular chain reconstruction (OCR).To describe the normal Cone Beam Computed Tomography (CBCT) appearance of the middle ear after various types of tympanoplasty and OCR.To discuss the CBCT features of common postoperative complications, e.g., prosthesis dislocation and fracture, graft necrosis and recurrence of middle ear pathology.
Read more Background Cone Beam Computed Tomography (CBCT) is currently routinely used as a low-radiation dose alternative for temporal bone (TB) imaging. High-resolution CT has long been the imaging modality of choice for patients with conductive/mixed hearing loss, as it accurately depicts the clinically and surgically important middle-ear structures and bony labyrinth. It is still used in many institutions instead of CBCT.Tympanoplasty, routinely combined with mastoidectomy and OCR is a surgical procedure designed to reconstruct the sound transmission mechanism of the middle ear...
Read more Findings and procedure details CBCT images of the TB are typically acquired with very thin slices and a small field of view to ensure the smallest possible voxel size (usually 0.15mm) and without intravenous contrast material.Multiplanar reconstructions are essential for improved assessment of TB anatomy and of postoperative changes. Sagittal oblique planes parallel (Pöschl) or perpendicular (Stenvers) to the superior semicircular canals (SSCC) are useful for illustrating the long axes of the malleus and incus. Moreover, the Pöschl projection provides one of the best...
Read more Conclusion Postoperative evaluation of the middle ear with CBCT/CT can be challenging because of different existing types of tympanoplasty and OCR procedures, as well as their combinations. Familiarity with the normal post-surgical middle ear and EAC aspect and recognition of abnormal findings are essential to avoid unnecessary procedures and to detect complications, thus contributing to appropriate therapeutic decisions.
Read more References Torizuka T, Hayakawa K, Satoh Y, Tanaka F, Okuno Y, Maeda M, Mitsumori M, Mimake S, Konishi J. Evaluation of high-resolution CT after tympanoplasty. J Comput Assist Tomogr 1992; 16:779–83 (DOI: 10.1097/00004728-199209000-00020). Stone JA, Mukherji SK, Jewett BS, Carrasco VN, Castillo M. CT evaluation of prosthetic ossicular reconstruction procedures: what the otologist needs to know. RadioGraphics. 2000; 20:593-605 (https://doi.org/10.1148/radiographics.20.3.g00ma03593). Merchant SN, Rosowski MJ, McKenna MJ. Operative techniques in otolaryngology—HEAD AND NECK Surgery, 2003; 14(4):224-236 (http://dx.doi:10.1053/S1043-1810(03)00092-7). Tames HL, Padula M, Sarpi MO, Gomes RL,...
Read more
GALLERY