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Imaging of the Postoperative Middle Ear, Mastoid, and Internal Auditory Canal

Introduction Interpretation of CT or MR imaging examinations performed on patients with a history of middle ear (ME), mastoid, or neurotologic surgery can be challenging. This is greatly simplified by knowing the surgical procedures used and the expected postoperative appearance. Knowledge of the normal postoperative appearance and the current clinical situation is the key to recognizing recurrent disease. The goal of surgery in the ME, mastoid,…

Imaging of the Facial Nerve

Anatomy The facial nerve comprises motor, sensory, and parasympathetic fibers. The dominant motor component comprises 70% of the total axons. The sensory component makes up much of the remaining portion of the nerve and includes the nervus intermedius (nerve of Wrisberg). The motor division supplies somatic motor fibers to the muscles of the face, scalp, and auricle; the buccinators; the platysma; the stapedius; the stylohyoideus; and…

Update on Imaging of Hearing Loss

Disclosure Disclosure of any relationship with a commercial company that has a direct financial interest in subject matter or materials discussed in article or with a company making a competing product. Introduction In the imaging evaluation of hearing loss, the radiologic examination is complementary to the physical examination. The clinical evaluation includes not only an accurate history of the hearing loss itself (unilateral or bilateral, slow…

Temporal Bone Trauma

Temporal Bone Pseudofractures—Fracture Mimics An important challenge in detecting and classifying temporal bone fractures is the inherent complexity of the temporal bone anatomy. Although the evaluation of symmetry is helpful to distinguish normal anatomy from acute injury, temporal bone sutures or fissures and canals can still be wrongly interpreted as fractures. The temporal bone has a complex structure. It is a part of the lateral wall…

Temporal Bone Tumors

Introduction This chapter presents an overview of tumoral lesions of the temporal bone. These lesions can be considered to be rather rare. Imaging plays a crucial role in describing the exact extent of these tumors and can be helpful in specifying some of these lesions. Classification of temporal bone tumors can be done in various ways. It can be based on the location and origin, age…

Temporal Bone Inflammatory and Infectious Diseases

Acknowledgments I thank Nancy Verpoort who spent a considerable amount of time editing the figures and texts. Introduction In a wide variety of inflammatory and infectious diseases of the temporal bone, imaging studies are used to determine the extent of the disease and to visualize eventual complications. Imaging protocols for the evaluation of infections in the external ear, the middle ear (and mastoid), and the inner…

Imaging in Endoscopic Endonasal Skull Base Surgery

Introduction The endoscopic endonasal approach has become the preferred surgical approach to many tumors of the ventral skull base, both benign and malignant. Although advances in surgical equipment and technique have played a role in the development, imaging remains one of the cornerstones to the endoscopic endonasal approach, playing an important role in the diagnosis from the preoperative planning stage to intraoperative navigation, postoperative complications, and…

The Sphenoid Bone

The sphenoid bone is located at the central skull base and is commonly considered the most complex bone in the human body. Although the sphenoid bone is often neglected in relation to the adjacent temporal bone, it forms the major boundary between the intra- and extracranial structures. The various sphenoid foramina to the orbits anteriorly and neck spaces inferiorly are pathways for transmission of disease. This…

Imaging of the Paranasal Sinuses and Their Surgical Relevance

One of the earliest computed tomography (CT) evaluations of the paranasal sinuses was published by Hesselink et al. in 1978 as a two-part series: describing both normal and pathologic anatomy. Early CT studies were performed only in the axial and coronal planes, but with the availability of multiplanar high-resolution CT, more complex imaging anatomy and anatomic variations have been documented. As such, preoperative CT has gained favor…

Anterior Skull Base

The anterior skull base is a region of interest because it is frequently breached by aggressive disease such as malignancy and infection or even chronic long-standing but progressive lesions such as mucoceles. This resultant transcompartmental spread has a significant impact in prognosis and management. Imaging plays a key role in the assessment of disease extent and management planning. Most tumors that involve the anterior skull base…