TEMPORAL BONE IMAGINGSasan Dabiri, M.D.

Assistant Professor

Department of ORL-HNS

Amir Alam Hospital - TUMS

IMAGING MODALITIES

CT

Bone

Soft

Without Contrast

With Contrast

MR

Spin Echo

Single SE

T1 , T1+

T2 ,

Proton Density

Multiple SE

FSE , TSE

Inversion Recovery

STIR , FLAIR

MR

Gradient Echo

Diffusion Weighted

EPI

Non-EPI

Single-shot

Multi-shot

Balanced GE (FIESTA)

Steady State GE (FISP)

Hybrid Echo

Anatomy is the Basis of Surgery,

it informs the head,

guides the hand, and

familiarizes the heart to

a kind of necessary inhumanity.William Hunter

1718 - 1783

www.boundless.com

TEMPORAL COMPARTMENTS

External Auditory Canal

Middle Ear and Mastoid

Inner Ear Cochlea

Vestibule

Semicircular Canals

Internal Auditory Canal

Petrous Apex

Cerebello-Pontine Angle

Facial Nerve

CORONAL PLANE – RIGHT EAR

CORONAL PLANE – RIGHT EAR

CORONAL PLANE – RIGHT EAR

CORONAL PLANE – RIGHT EAR

AXIAL PLANE – RIGHT EAR

AXIAL PLANE – RIGHT EAR

AXIAL PLANE – RIGHT EAR

AXIAL PLANE – RIGHT EAR

AXIAL PLANE – RIGHT EAR

AXIAL PLANE – RIGHT EAR

EAC Cavity

Cochlea

SCCs

IACVestibule

AXIAL PLANE – RIGHT EAR

Normal Imaging

NORMAL FINDINGS

Pseudo-fractures

Extrinsic Fissures &

Sutures

NORMAL FINDINGS

Pseudo-fractures

Intrinsic Fissures

Petrotymanic or glaserian(chorda)

Petrosquamosal (koerner)

Tympanosquamosal (align to ant. of EAC)

Tympanomastoid (align to post. of EAC)

Abnormal Findings

DIFFERENTIAL DIAGNOSES

Common External Auditory Canal Abnormalities

Congenital

Atresia

Inflammatory – Infection

Cholesteatoma

Skull base Osteomyelitis

Neoplasm

Benign : Osteoma , Exostosis

Malignant : SCC

DIFFERENTIAL DIAGNOSES

Common Middle Ear & Mastoid Abnormalities

Congenital

Vascular (carotid, jugular)

Inflammatory – Infection

Cholesteatoma

Mastoiditis

Colesterol Granuloma

Neoplasm

Benign : Glomus

Malignant : Metastasis

DIFFERENTIAL DIAGNOSES

Common Inner Ear Abnormalities

Congenital

Large Vestibular Aqueduct

Semicircular canal Dehiscence

Otosclerosis

Inflammatory – Infection

Labyrinthitis

Neoplasm

Schwannoma

Endolymphatic Sac Tumor

DIFFERENTIAL DIAGNOSES

Common Petrous Apex Abnormalities

Pseudo-lesions

Congenital

Cephalocele

Inflammatory – Infection

Petrous Apicitis

Cholesterol Granuloma

Neoplasm

Chondrosarcoma

Metastasis

DIFFERENTIAL DIAGNOSES

Common Facial Nerve Abnormalities

Congenital

Venous Malformation

Inflammatory – Infection

Bell’s palsy (herpetic neuralgia)

Neoplasm

Schwannoma

Perineural Tumor spread

REFERENCES

o https://www.boundless.com/physiology/textbooks/boundless-anatomy-and-physiology-textbook/the-skeletal-system-7/the-skull-79/cranial-bones-459-8856/ (last accessed: Jul 2015)

o http://www.med.wayne.edu/diagRadiology/Anatomy_Modules/axialpages/Overview.html(last accessed: Jul 2015)

o http://teachmeanatomy.info/head/osteology/temporal-bone/ (last accessed: Jul 2015)

o Imaging of the Head & Neck, Mafee

o Head & Neck Imaging, Som

o Imaging of the Temporal Bone, Radiolodic clinics

THANKS FOR YOUR ATTENTION