POSTER SECTIONS Coverpage Learning objectives Background Findings and procedure details Conclusion Personal information and conflict of interest References

ECR 2024 / C-13011

Middle ear «normal» and «abnormal» after a tympanoplasty

Congress:

ECR 2024

Poster Number:

C-13011

Type:

Educational Exhibit

Keywords:

Ear / Nose / Throat, Head and neck, Cone beam CT, Image manipulation / Reconstruction, Complications, Surgery, Treatment effects, Developmental disease, Prostheses, Tissue characterisation

Authors:

S. E. Chiriac, N. Guinand, P. Senn, M. Becker

DOI:

10.26044/ecr2024/C-13011

DOI-Link:

https://dx.doi.org/10.26044/ecr2024/C-13011

Background

Cone Beam Computed Tomography (CBCT) is currently routinely used as a low-radiation dose alternative for temporal bone (TB) imaging. High-resolution CT has long been the imaging modality of choice for patients with conductive/mixed hearing loss, as it accurately depicts the clinically and surgically important middle-ear structures and bony labyrinth. It is still used in many institutions instead of CBCT.

Tympanoplasty, routinely combined with mastoidectomy and OCR is a surgical procedure designed to reconstruct the sound transmission mechanism of the middle ear with the following objectives: limitation of disease, alteration of anatomy to prevent recurrent disease, and reconstruction of the middle ear to achieve serviceable and stable postoperative hearing.

For many radiologists, the anatomic complexity of the (TB) and the variety of surgical procedures that are performed in this area can be quite challenging in terms of evaluation at cross-sectional imaging.

Fig 1: Normal anatomy of the right middle ear a) Sagittal oblique plane (Pöschl –...

Fig 2: The Wullstein classification of tympanoplasty. (LSCC = lateral semicircular...

Fig 3: Normal postoperative right ear after Type I myringoplasty - this consists in...

Fig 4: Normal right ear after tympanoplasty- Type III in 2 different patients : this...

Fig 5: Normal left ear after tympanoplasty - Type IV: this consists in placing the TM...

Fig 6: Normal right ear after tympanoplasty - Type V: this is an example of a type...

Fig 7: Prostheses of different designs and materials as used in clinical routine.

Fig 8: Types of Ossicular Chain Reconstruction (OCR).

Fig 9: Two different types of autologous ossiculoplasty using the malleolus head and...

Fig 10: Normal ears after tympanoplasty type III - minor columella reconstruction....

Fig 11: Normal left ear after PORP (Partial Ossicular Replacement Prosthesis, arrows) -...

Fig 12: Two different patients with normal left ears TORP (Total Ossicular Replacement...

Fig 13: Two different patients (patient A - right ear; patient B - left ear) with...

Fig 14: Necrosis of the tympanomeatal flap and of the cartilage with perichondritis...

Fig 15: Displacement of malleus-columella (arrows) in the left ear.

Fig 16: Recurrent cholesteatoma (arrows) with non-visualization of a previously...

Fig 17: Prosthesis subluxation Medial extremity of the TORP displaced into the sinus...

Fig 18: Prosthesis subluxation - Disjunction between prostheses Medial extremity of...

Fig 19: Development of granulation tissue (pink arrows) in the operated right ear on...

Fig 20: 3 different patients with obliterative otosclerosis (arrows) involving the oval...

Fig 21: Pneumolabyrinth with normal position of the PORP after barotrauma (without...