Normal inner ear
It is highly useful to get three-dimensional (3D) reconstruction of computed tomography (CT) images which will help in determining the anatomy and topographic relationship between various important structures in the temporal bone. 3D reconstruction based on the image data from spiral high-resolution CT using special software, is performed by segmentation, volume-rendering and surface-rendering algorithms on a personal computer. 3D CT is a valuable source of supplementary information on inner ear disease and ossicular chain discontinuity.
A 3D reconstruction of temporal bone CT might be useful not only for education and increasing understanding of the anatomical structures of the temporal bone but can be extremely useful in making better diagnosis of inner ear and middle ear diseases.
I have compared a small number of 3D CT images of temporal bones of normal individuals and those having clinically diagnosed ossicular chain discontinuity, Meniers disease (Labyrinthine Hydrops) and Benign positional vertigo(Otolith) cases, and I found amazing pictures confirming my clinical diagnosis. It was found that 3D-CT was useful in observing the minute structure of the inner ear in that it could ascertain spatial relationships and minute constrictions and protrusions that could not be detected by 2D analysis
“Rosary bead” (Paulo sign) appearance of Semicircular canal.
Among many patients diagnosed as Benign Positional vertigo who under went 3D Ct imaging, two interesting findings were reported by the radiologist. The typical findings are of a Rosary bead appearance of one of the semicircular canals. Clinically these two patients had vertigo on moving the neck to that particular orientation of the semicircular canal.
Both cases were slow to response when given betahistine and cinnarzine.One patient improved her symptoms when given a course of Deflazacort.
Those who are investigating cases of vertigo, a 3D CT may reveal newer findings like this and this area needs more studies.
(I haven\’t heard anyone reported similar findings anywhere, hence the term –Rosary bead-Paulo sign)
*Courtesy to Dr Asha FRCR, Mr G.S.Vergin, Travancore Scans, Trivandrum.
*Copying the above pictures without permission is immoral. I will oblige to give more pictures for further study and research, on request.
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