Vertigo – 3D CT Images of inner ear.

3D multiplanar reformatted images from conventional CT data gives a better understanding of anatomy and pathology of Temporal bone.

Recent developments in software technology have made it possible to rapidly generate 3D volumes from conventional 2D data. These volume-rendered (VR) images can be sectioned in any plane and rotated in space, allowing 3D insight into the anatomy of the temporal bone.

3D Volume rendered (VR CT) images are very helpful to see the intricate anatomy of the inner.

3D VR CT images are very useful in studying the congenital malformations, inflammatory process, neoplasm, Trauma etc. These 3 D images are a valuable too for ENT surgeons treating inner and middle ear disorders.

In the following Case study , a 40 year old Indian male sustained head injury after he fell off the bike and hit left side of his head 5 years ago. Since last 2 years he is having recurrent attacks of vertigo with mild sensori neural hearing loss in the left ear.

normal rt inner ear1normal rt inner ear2normal rt inner ear3

The right ear 3D images shows absolute normal inner ear.(pictures above)

left ear obstructed s canal2left ear obstructed s canal4left ear obstructed s canal5left ear obstructed s canal7left ear obstructed s canal 8

Left ear shows beaded appearance- narrowing of the lateral semicircular canal.

The pictures are reconstructed in different angle, and shows consistent findings.

It can be a post traumatic stricture or narrowing.

The patient is having incapacitating vertigo, being treated with Betahistine, Cinnarzine, and vasodilators without any improvement.

MRI 1MRI3

MRI Scan of the same patient

I have given Methyl prednisolone which showed some improvement.

It is a clinical dilemma, any body reading this article, may give your suggestion, if any.