Imaging Studies of the Temporal Bone(II)精选.pptVIP

Imaging Studies of the Temporal Bone (II) Inner Ear 20% of patients with congenital sensorineural hearing loss have morphologic anomalies 4 ~8 weeks of gestation, labyrinth forms Michel Aplasia Complete absence of the inner ear Developmental arrest at 3rd week Mondini Cochlear Deformity Failure of partition of the cochlea Cochlear apex appears bulbous Associated with an enlarged vestibular aqueduct Horizontal semicircular deformities are the most common discovered Congenital SNHL The most common inner abnormality is enlarged vestibular aqueduct (EVA) Greater than 1.5mm wide (approximately the width of the posterior semicircular canal) Superior Semicurcular Canal Dehiscence An absence of a small portion of bone in the otic capsule Sound or pressure induced vertgio (Tullio phenomenon) Labyrinthitis T1W enhanced Not identifiable on CT Intralabyrinthine Schwannoma Typically found in the IAC extending into labyrinth Indistinguishable from labyrinthitis Endolymphatic Sac Tumor Benign but locally aggressive CT detectable by erosion of aqueduct wall Bony spicules similar to glomus jugulare tumor Otodystrophies (1)Otosclerosis Otosclerosis (otospongiosis) is enchondral bone replaced by spongy vascular irregular bone Later, spongy bone cecomes calcified and sclerotic The most commonly involved site is anterior to the oval window Otodystrophies (2) Osteogenesis Imperfecta with similar marked demineralization Paget disease, fibrous dysplasia, and osteoporosis can affect the temporal bone but rarely involved the otic capsule and less likely to cause SNHL Fractures Longitudinal, transverse, or mixed according to orientation relative to the long axis of the petrous bone. Fluid in the middle ear may represent hemotympanum or CSF leak. Longitudinal Fractures Most common (75%) From mastoid process through the path of least resistance to the petrous apex Otic capsule injury is rare Commonly associated with a ruptured tympanic membrane and hemotympanum Transverse Fractures Perpendi