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
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
NORMAL FINDINGS
Pseudo-fractures
Intrinsic Fissures
Petrotymanic or glaserian(chorda)
Petrosquamosal (koerner)
Tympanosquamosal (align to ant. of EAC)
Tympanomastoid (align to post. of EAC)
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