Imaging of otosclerosis

University of Illinois, Chicago.
Otolaryngologic Clinics of North America (Impact Factor: 1.49). 07/1993; 26(3):359-71.
Source: PubMed


Imaging studies play an important role in the diagnosis of otosclerosis and in the clinical management of this disease. CT scanning at present is the tool of choice for the assessment of the labyrinthine windows and cochlear capsules. MR imaging thus far has had limited applications in the examination of the cochlear capsules but has been more useful in the assessment of the cochlear lumen prior to cochlear implant in patients with profound bilateral hearing loss.

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    ABSTRACT: To determine the diagnostic value of tympanocochlear scintigraphy (TCS), which is still used for the visualization of alterations of labyrinthine bone metabolism due to active otosclerosis, resolution and detection limits were examined in a normal human temporal bone model. After incubation in technetium-99m-labeled diphosphonate solution, scintigraphic imaging showed the zygomatic process and the clivus as landmarks for fine structures of the petrous bone. For further differentiation, labyrinthine fine structures were marked with radioactive tracers of 0.5-1 mm2 each. High-resolution scintigraphic imaging gave two-point discrimination for structures as small as 2.5 mm apart. Localization of the activity patterns was improved by correlating imaging with X-ray photographs or by superimposition with masks of the prepared temporal bones drawn from the X-rays. The correlation of scintigraphic findings with X-ray photographs was found to provide a powerful method for improving the accuracy of localizing temporal bone metabolic changes as it is applicable clinically for studying the occurrence of small active otosclerotic foci.
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    ABSTRACT: Die magnetresonanztomographische (MRT-)Untersuchung des Felsenbeines hat in den letzten Jahren zunehmend an Bedeutung gewonnen. Neu entwickelte Sequenzen ermöglichen eine deutlich verbesserte Darstellung anatomischer Details. Die Autoren beschreiben die diagnostischen Möglichkeiten der MRI zur Untersuchung von Innenohrfehlbildungen, entzündlichen Erkrankungen, Neoplasien und Knochendystrophien des Felsenbeines. Die MRT ist der Computertomographie (CT) in der Darstellung von Veränderungen im Bereich des inneren Gehörgangs überlegen. Die MR-Bildgebung ermöglicht das Auffinden kleiner Tumoren und die Auflösung von Veränderungen der Nerven des inneren Gehörganges. Der Nachweis angeborener Innenohrfehlbildungen ist mit der MRT und CT in vergleichbarer Weise möglich. Die Ausdehnung von Raumforderungen im Felsenbein und in seiner Umgebung läßt sich in der MRT besonders übersichtlich abbilden. Unklar bleibt die Wertigkeit der MRT zur Beurteilung der aktiven Otosklerose. Magnetic resonance imaging (MRI) of the temporal bone has become more important the last few years. The recent development of sequences allows a significant increase of anatomic resolution. MRI depicts all of the small labyrinthine elements that previously could only be visualized with high-resolution computed tomography (CT). The authors describe the diagnostic potentials of MRI in analyzing congenital inner ear malformations, inflammatory lesions, neoplasms, otosclerosis, and dysplasias of the temporal bone. MRI is superior to CT in imaging lesions in the inner auditory canal. MRI allows detection of small tumors and depiction of lesions of the nerves in the inner auditory canal. MRI is as sensitive as CT demonstrating congenital inner ear malformations. Tumor invasion in the temporal bone and tumor spread in surrounding structures is well demonstrated by MRI. The value of MRI in patients with active otosclerosis is not yet clear.
    No preview · Article · Mar 1999 · Clinical Neuroradiology
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