Professional Documents
Culture Documents
Submitted by
DR. ANJALI DESHMUKH
Resident in MD RADIOLOGY
MGM Medical College and Hospital,Aurangabad.
INTRODUCTION
• The temporal bone is a complex anatomic structure that contains
the organs of hearing and balance. In addition, major vessels and
nerves course through it and it also has a close proximity to the
brain. Temporal bone has direct contact with brainstem, cerebellum
and temporal lobe of brain. Before computed tomography (CT)
imaging modalities available for the evaluation of temporal bone
were plain radiograph, polytomography, angiography, and
cisternography. Plain radiograph remains inexpensive tool of the
study of temporal bone but has major limitations due to complex
anatomy and overlapping of various bony structures.
• High-resolution computed tomography (HRCT) offers excellent
spatial and density resolution using special algorithms. It provides
information not only about bony outline but also soft tissue
changes making it possible to demonstrate the location and extent
of disease as well as its complications. Furthermore, coronal and
axial CT scanning together has dramatically improved the imaging
of temporal bone. HRCT accurately depicts the boundaries
between the external, middle and inner ear cavities thereby
localized the disease precisely and also greatly demarcate thin
boundary between temporal bone and intracranial compartment
with exact details of intracranial spread of primary temporal bone
disease. Contrast media help to evaluate the vascularity and
contrast enhancing characteristics particularly in soft tissue lesions
of temporal bone giving clues to the histopathology.
AIM AND OBJECTIVES
AIM
To study the role of Role of high resolution computed
tomography in evaluation of temporal bone pathologies.
OBJECTIVES
1. To evaluate pathologies of temporal bone such as congenital
anomales, infections, trauma, neoplasms and their disease
distribution.
2. To evaluate the extent of pathological process and sites of
involvement of the middle ear and the mastoid air cell system in
these patients.
3. To study the intracranial complications.
4. To study the relationship of the tympanomastoid
compartment to the adjacent , critical neurovascular structures .
REVIEW OF LITERATURE
STUDY DURATION: Study will be done for a period of 2 years after approval from
ethical committee.
FULFILMENT NON-FULFILMENT
INFORMED CONSENT
STUDY EXCLUSION
HISTORY:
PRESENTING COMPLAINTS:
1. Ear discharge : `Side, Onset, Duration, Amount, Type of discharge,
Aggravating / Relieving Factors, Response to
treatment
2. Hard of hearing : Side, Acute / Insidious, Degree Progressive
/continuous/
Intermittent , Whether handicapping, Family
history,
H/o trauma to ear,
H/o exposure to loud nice.
3. Earache : Duration, Side, Mild/Server, More on movement of
ear /
during mastication, Increase during ear discharge or
not
4. Giddiness : Duration, Intermittent / Continuous, Associated
with
posture, H/o intake of ototoxic drugs, Aggravating /
relieving factors.
5. Tinnitus : Side, Unilateral / Bilateral, Duration, Sudden /
Gradual,
• Progression – Severe / Static / Decreasing,
Continuous / intermittent/ Pulsatile/ Clicking,
Aggravating / Relieving factors.
6. Headache/ vomiting
7. Fever
8. Facial weakness
• MENSTRUAL HISTORY
PERSONAL HISTORY:
FAMILY HISTORY :- H/O HOH, H/O Consanguinous marriage
PAST HISTORY :- H/O Previous surgery,
H/O Ototoxic drug intake as in TB.
H/O DM/HTN
EXAMINATION OF EAR:
R L
Pinna
•
Preauricular area
Postauricular area
EAC
Tympanic Membrane:
•
Mastoid tenderness
Tragal tenderness
Fistula test
• TUNING FORK TESTS
Rinne‟s
Weber‟s
ABC
• Facial Nerve:
Romberg‟s:
Examination of Oral Cavity/ Oropharynx / Nose
Palate : Bulge/ Movements of soft palate, postnasal drip, tonsils, posterior
pharyngeal
wall, Dental hygiene.
SYSTEMIC EXAMINATION
RS CNS : Higher functions, Cranial Nerves, Sensory, Motor,
Reflexes, Gait, Cerebellar System, Speech
CVS
Abdomen
INVESTIGATIONS:
Blood - Hb, TC, DC, ESR
Urine - Routine, Microscopy
Pus - Culture/ Sensitivity
CT Temporal bones :- Axial / Coronal views
Plain / Contrast
•
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