Preoperative study of the petrous bone with multidetector CT (MDCT): identification of anatomical risky conditions in otosurgery.

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Congress:

ECR 2014

Poster Number:

C-1031

Type:

Scientific Exhibit

Keywords:

Epidemiology, Education and training, Normal variants, Decision analysis, CT-High Resolution, Head and neck, Ear / Nose / Throat, Anatomy

Authors:

G. Coniglio, M. L. Lanza, A. uccello, M. Coppolino, A. Montana, G. C. Ettorre; Catania/IT

DOI:

10.1594/ecr2014/C-1031

DOI-Link:

https://dx.doi.org/10.1594/ecr2014/C-1031

Fig. 1: Asymmetric jugular bulb (asterisk)

Fig. 2: High-riding jugular bulb(white arrow)extending over basal turn of the cochlea

Fig. 3: Axial (A) CT image shows jugular bulb protruding in the middle ear; coronal CT...

Fig. 4: Anteriorly located right sigmoid sinus. A protrudent right jugular bulb in the...

Aims and objectives

The aim of this study is to retrospectively analyze a series of temporal bone high-resolution CT scans for the incidence of anatomical variations of both vascular and non vascular structures, highlighting how these variations may cause important problems in diagnosis and treatment planning.

Methods and materials

We retrospectively searched our radiology data base for all temporal bone CT scans performed over a 21-months period from January 2012 through September 2013. Consecutive unhenanced temporal bone CT scans in 174 patients were identified, consisting of axial images acquired with a 16-slice CT scanner (Brilliance-16-MDCT, Philips Healthcare), using a high resolution temporal bone protocol. Multiplanar reconstructed images with 0.70 mm slice thickness were obtained from CT images performed in the axial plane at a separate workstation.

Results

Anatomical variations were observed in 41 patients of 174 (24%). The conditions most often encountered are: high or protruding bulb of the jugular vein 23 (13%), mastoid emissary vein 7 (4%), anterior placed sigmoid sinus 4 (2%), facial nerve dehiscence 4 (2%). Abnormalities of mastoid pneumatization and surgical landmarks are also considered. Below these variants are described; important anatomical variants not encountered in our series are also mentioned. The jugular bulb (JB) is the confluence of the lateral venous sinuses situated in the jugular fossa....

Conclusion

Conclusion Anatomical variations of the temporal bone are not rare . Preoperative radiological evaluation with MDCT may prevent neurovascular injuries and contribute to surgical success by recognition of possible variants that, if undetected, may pose a hazard in the course of otosurgery

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References

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