Pathology of the ossicular chain: comparison between virtual endoscopy and 2D spiral CT-data

Abstract

Objective: The purpose of this study was to assess the value of virtual endoscopy (VE) in the diagnosis of lesions of the ossicular chain and to compare virtual endoscopy and two-dimensional (2D) spiral computed tomography (CT) data.

Study design: Retrospective study.

Setting: A university hospital.

Patients: Fifty-eight patients with suspected ossicular chain lesions underwent a high-resolution CT of the temporal bone with both 2D data and VE before surgery.

Main outcome measures: Two views were chosen for VE. The CT data obtained (2D, VE, and both 2D and VE) were compared with the lesions noted during surgery.

Results: In the diagnosis of dislocation of the ossicles or prostheses, VE seemed to be a better technique than 2D CT. Views chosen for the VE proved to be ineffective for diagnosing epitympanic fixations. VE was not adapted to the study of otosclerosis. We found it necessary to use the data provided by the addition to 2D CT data in the diagnosis of ossicular lysis and minor aplasia. Radiologic analysis of the lesions of the long process of the incus and the incudostapedial joint was improved by performing both 2D CT and VE. VE reconstruction of the stapes proved to be difficult, especially in cases of inflammation of the middle ear.

Conclusion: This study demonstrates the value of VE in the diagnosis of dislocation of the ossicles and ossicular prostheses. VE was less effective in diagnosing other pathologies of the ossicular chain.