"Can You Hear Me Now?": A Pictorial Review of Temporal Bone Infections and Common Complications

Congress:

ECR 2019

Poster Number:

C-3053

Type:

Educational Exhibit

Keywords:

Infection, Abscess, Education, MR, CT, Head and neck, Ear / Nose / Throat, Bones

Authors:

L. C. Figueroa-Diaz¹, M. Betancourt-Torres², A. Saldana³, J. R. Ortiz-Cruz³, F. G. Rodriguez-Ruiz⁴, D. E. Labat⁵, L. E. Garcia-Irizarry¹; ¹San Juan, PR/US, ²Hato rey, PR/US, ³San Juan, Puerto Rico/US, ⁴Caguas, Puerto Rico/US, ⁵San Juan /US

DOI:

10.26044/ecr2019/C-3053

DOI-Link:

https://dx.doi.org/10.26044/ecr2019/C-3053

Fig. 6: Axial bone window image (a) demonstrates extensive soft tissue swelling and...

Fig. 7: Axial images of non-enhanced head CT (a, b) show partial opacification of the...

Fig. 8: Coronal image of a contrast-enhanced neck CT scan (a) shows subtotal mastoid...

Fig. 10: Axial (a) and coronal (b) images of a temporal bone CT demonstrate complete...

Learning objectives

1. Review basic anatomy of the temporal bone. 2. Provide a comprehensive list of temporal bone infections and common complications. 3. Discuss pertinent imaging findings in computed tomography (CT) and magnetic resonance imaging (MRI). 4. Discuss the importance of accurate diagnosis and management of temporal bone infections and possible complications.

Background

The temporal bone has a complex anatomy and three-dimensional arrangement. It forms parts of the lateral skull base, as well as part of the middle and posterior cranial fossa. The temporal bone can be divided into five parts: squamous, mastoid, petrous, tympanic and styloid process. Squamous part: The squamous portion forms the anterior and superior part of the temporal bone and contains the petrotympanic fissure which transmits the chorda tympani branch of the facial nerve. The inferior part forms a projection called the zygomatic process,...

Findings and procedure details

I. Temporal Bone Infections: A. Acute Otitis Media Several infectious processes can affect the temporal bone and can be described on imaging by the involvement of different regions of the temporal bone: external ear, middle ear, internal ear/mastoid process and petrous apex. Most common inflammatory condition of the temporal bone is acute otitis media. Acute otitis media (AOM) is a common infection among children, commonly caused by Streptococcus and Haemophilus Influenza, often occurring as a disruption of the mucosal barrier due to a previous viral...

Conclusion

Infectious processes affecting the temporal bone are commonly encountered. The most common infectious process involving the temporal bone is acute otitis media, which can be the result of an upper respiratory infection or the spread of bacteria. Acute otitis media has non-specific imaging findings, the reason why imaging is reserved to evaluate possible complications that may arise as a consequence of otitis media. High resolution CT (temporal bone CT protocol) provides adequate detail of the temporal bone and MRI provides additional complementary information about the...

Personal information

References

[1] Gray, H. (2012).Anatomy of the human body. London, England: Bounty. [2] Juliano, A. F., Ginat, D. T., & Moonis, G. (2013). Imaging Review of the Temporal Bone: Part I. Anatomy and Inflammatory and Neoplastic Processes.Radiology,269(1), 17-33. doi:10.1148/radiol.13120733 [3] Kumar Lingam, R., Kumar, R., & Vaidhyanath, R. (2019). Inflammation of the Temporal Bone.Neuroimaging Clinics,29, 1-17. doi:10.1016/j.nic.2018.08.003 [4] Lemmerling, M. (2018). Temporal Bone Inflammatory and Infectious Diseases.Skull Base Imaging,83-97. doi:10.1016/b978-0-323-48563-0.00005-2 [5] Lo, A., & Nemec, S. (2015). Opacification of the middle ear and mastoid: Imaging findings...