3-Dimensional (3D) multiplanar reformatted images from conventional cross-sectional CT data have been increasingly used to demonstrate the anatomy and pathologic conditions of middle and inner ear structures.
Temporal bone includes many small strucÂ¬tures within a very compact region, some measuring well under 1 mm. Their multi-spatial orientation makes it difficult to conceptualize the intricate three-dimensional (3D) relationship of these structures based on conventional two-dimenÂ¬sional (2D) imaging.
To obtain good 3D reconstructions, it is absolutely essential to obtain the thinnest possible overlapping slices and good soft ware and skill of the Radiographers, of course they need achieve a learning curve to make the images faster.
These images can be rotated in space and dissected in any plane, allowing assessment of the morphologic features of individual structures, including the small ossicles of the middle ear and the intricate components of the inner ear.
3D-CT is useful in observing the minute structure of the inner ear in that it could ascertain spatial relationships and minute constrictions (Rosary bead-Paulo Sign-see below) and protrusions that could not be detected by 2D analysis. This is also capable of assessing the stage of embryological injuries and evaluating anomalies in cochlear turning that are the hidden factors of hearing impairment.
3D VR CT images can be used to evaluate various conditions of the temporal bone, including congenital malformations, vascular anomalies, inflammatory or neoplastic conditions, and trauma.
Use of 3D CT (VR) for ENT Surgeons
The information provided by 3D reformatted images allows a better understanding of temporal bone anatomy and improves the ability to evaluate related disease, thereby helping to optimize surgical planning as follows-
1-No more Exploratory Tympanotomy needed to find the middle ear pathology
2-Very useful in planning Stapedectomy operation
3-Very useful before Cochlear implant Surgery
4-Diagnosis of various causes of Vertigo, inner ear pathology
5-Planning surgical treatment in Congenital Ear abnormalities
(Pictures Courtesy to Mr. D.Reji and Ms Preetha- Radiograhers -SUT Hospital Trivandrum)
For more pictures visit Gallery-
Rosary Bead -Paulo sign-in 3D CT, please read