Neuroimaging clinics of North America
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Neuroimaging Clin. N. Am. · Feb 2019
ReviewImaging of Temporal Bone Trauma: A Clinicoradiologic Perspective.
Imaging plays an important role in the evaluation of temporal bone trauma. Certain imaging findings can significantly change patient management or change surgical approach. Precise knowledge of clinical or surgical management can guide the review of imaging to detect these key findings. This article reviews the clinical and imaging findings as well as management of complications from temporal bone trauma, including hearing loss, vertigo, perilymphatic fistula, cerebrospinal fluid leak, facial nerve injury and vascular injury.
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Neuroimaging Clin. N. Am. · Feb 2019
ReviewCommon Otologic Surgical Procedures: Clinical Decision-Making Pearls and the Role of Imaging.
Neuro-otologists rely on the expertise and judgment of a skilled neuroradiologist to identify radiographic abnormalities in the complicated regional anatomy of the temporal bone and middle and posterior fossa, and more importantly, to alert the surgeon to potential operative pitfalls. This article highlights some of the common otologic surgical procedures that stress this important dynamic. The surgical perspective on quick and effective clinical decision-making pearls to keep in mind during a thorough radiographic analysis of the ear and lateral skull base is presented.
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Many bone dysplasias, some common and others rare, may involve the temporal bone causing conductive, sensorineural, or mixed hearing loss, vestibular dysfunction, or skull base foraminal narrowing, potentially affecting quality of life. Some conditions may affect only the temporal bone, whereas others may be more generalized, involving different regions of the body. High-resolution computed tomography may detect subtle osseous changes that can help define the type of dysplasia, and MR imaging can help define the degree of activity of lesions and potential associated complications.
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Visualization of the morphologic substrate of Ménière disease, the endolymphatic hydrops, can be performed using noncontrast or contrast-enhanced MR imaging techniques. Noncontrast MR imaging uses a heavily T2-weighted sequence; however, its reproducibility remains to be confirmed. ⋯ The latter technique is most frequently used and is able to detect and grade Ménière disease. It is a reliable technique with a high diagnostic accuracy, enabling visualization of endolymphatic hydrops.
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Temporal bone and ear structure inflammation is commonly due to infection. It can be associated with a variety of complications and postinflammatory sequelae. Where the ear is easily inspected, clinical evaluation suffices. ⋯ High-resolution computed tomography scanning is suited for temporal bone imaging and is the modality of choice. MR imaging is useful to characterize disease, define the extent and spread of disease, or as a surveillance tool. MR imaging can be used with high-resolution computed tomography scanning to give a comprehensive evaluation of a complex disease process.