a basic description of temporal bone anatomy which is necessary for primary radiologic evaluation of temporal bone imaging and some important points and differential diagnoses in related imaging.

1. TEMPORAL BONE IMAGING
Sasan Dabiri, M.D.
Assistant Professor
Department of ORL-HNS
Amir Alam Hospital - TUMS

2. IMAGING MODALITIES
CT
 Bone
 Soft
 Without Contrast
 With Contrast
MR
 Spin Echo
 Single SE
 T1 , T1+
 T2 ,
 Proton Density
 Multiple SE
 FSE , TSE
 Inversion Recovery
 STIR , FLAIR
MR
 Gradient Echo
 Diffusion Weighted
 EPI
 Non-EPI
 Single-shot
 Multi-shot
 Balanced GE (FIESTA)
 Steady State GE (FISP)
 Hybrid Echo

3. Anatomy is the Basis of Surgery,
it informs the head,
guides the hand, and
familiarizes the heart to
a kind of necessary inhumanity. William Hunter
1718 - 1783

4. www.boundless.com

17. TEMPORAL COMPARTMENTS
 External Auditory Canal
 Middle Ear and Mastoid
 Inner Ear
 Cochlea
 Vestibule
 Semicircular Canals
 Internal Auditory Canal
 Petrous Apex
 Cerebello-Pontine Angle
 Facial Nerve

18. CORONAL PLANE – RIGHT EAR

19. CORONAL PLANE – RIGHT EAR

20. CORONAL PLANE – RIGHT EAR

21. CORONAL PLANE – RIGHT EAR

22. AXIAL PLANE – RIGHT EAR

23. AXIAL PLANE – RIGHT EAR

24. AXIAL PLANE – RIGHT EAR

25. AXIAL PLANE – RIGHT EAR

26. AXIAL PLANE – RIGHT EAR

27. AXIAL PLANE – RIGHT EAR

28. EAC Cavity
Cochlea
SCCs
IACVestibule
AXIAL PLANE – RIGHT EAR

29. Normal Imaging

30. NORMAL FINDINGS
Pseudo-fractures
Extrinsic Fissures &
Sutures

31. NORMAL FINDINGS
Pseudo-fractures
Intrinsic Fissures
Petrotymanic or glaserian
(chorda)
Petrosquamosal (koerner)
Tympanosquamosal (align to ant.
of EAC)
Tympanomastoid (align to post.
of EAC)

32. Abnormal Findings

33. DIFFERENTIAL DIAGNOSES
Common External Auditory Canal Abnormalities
 Congenital
 Atresia
 Inflammatory – Infection
 Cholesteatoma
 Skull base Osteomyelitis
Neoplasm
 Benign : Osteoma , Exostosis
 Malignant : SCC

34. DIFFERENTIAL DIAGNOSES
Common Middle Ear & Mastoid Abnormalities
 Congenital
 Vascular (carotid, jugular)
 Inflammatory – Infection
 Cholesteatoma
 Mastoiditis
 Colesterol Granuloma
Neoplasm
 Benign : Glomus
 Malignant : Metastasis

35. DIFFERENTIAL DIAGNOSES
Common Inner Ear Abnormalities
 Congenital
 Large Vestibular Aqueduct
 Semicircular canal Dehiscence
 Otosclerosis
 Inflammatory – Infection
 Labyrinthitis
 Neoplasm
 Schwannoma
 Endolymphatic Sac Tumor

36. DIFFERENTIAL DIAGNOSES
Common Petrous Apex Abnormalities
 Pseudo-lesions
 Congenital
 Cephalocele
 Inflammatory – Infection
 Petrous Apicitis
 Cholesterol Granuloma
 Neoplasm
 Chondrosarcoma
 Metastasis

37. DIFFERENTIAL DIAGNOSES
Common Facial Nerve Abnormalities
 Congenital
 Venous Malformation
 Inflammatory – Infection
 Bell’s palsy (herpetic neuralgia)
Neoplasm
 Schwannoma
 Perineural Tumor spread

43. REFERENCES
o https://www.boundless.com/physiology/textbooks/boundless-anatomy-and-physiology-
textbook/the-skeletal-system-7/the-skull-79/cranial-bones-459-8856/ (last accessed: Jul 2015)
o http://www.med.wayne.edu/diagRadiology/Anatomy_Modules/axialpages/Overview.html
(last accessed: Jul 2015)
o http://teachmeanatomy.info/head/osteology/temporal-bone/ (last accessed: Jul 2015)
o Imaging of the Head & Neck, Mafee
o Head & Neck Imaging, Som
o Imaging of the Temporal Bone, Radiolodic clinics

44. THANKS FOR YOUR ATTENTION