Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology · 2012
Otosclerosis: anatomy and pathology in the temporal bone assessed by multi-slice and cone-beam CT.
СтатьяПоддержка исследования: вне правительства СШАНазвание и аннотация: Перевод в очереди
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Redfors Ylva Dahlin, Gröndahl Hans Göran, Hellgren Johan, Lindfors Ninita, Nilsson Inger, Möller Claes
Аннотация
OBJECTIVE: To assess the use of cone beam computed tomography (CBCT) compared with multi-slice computed tomography (MSCT) in otosclerosis, with special emphasis on middle- and inner-ear anatomy.
STUDY DESIGN: Prospective study.
PATIENTS: Twenty patients who underwent a stapedectomy 30 years ago were selected on the basis of bone conduction threshold values. Their mean age was 65 years (range, 48-76 yr).
INTERVENTION: All patients underwent CBCT and MSCT with a slice thickness of 0.5 to 0.6 mm.
MAIN OUTCOME MEASURES: Sixteen middle- and inner-ear anatomic structures and stapedial prostheses were analyzed by visual grading analysis. To assess critical reproduction and thereby the clinical applicability of CBCT, a dichotomization was made. Assessment of otosclerotic foci was performed using a grading system dividing the lesions in; (1) sole fenestral lesions, (2) retrofenestral lesions with or without fenestral lesions and (3) severe retrofenestral lesions.
RESULTS: The 16 anatomic structures were clearly reproduced by both imaging techniques. However, there was an interobserver variation in judging the superiority of 1 method in favor of the other. Otosclerotic lesions were diagnosed in 80/95% using MSCT and 50/85% using CBCT (evaluators 1 and 2, respectively). Retrofenestral lesions were diagnosed in 5 of 10 of ears with severe-to-profound hearing loss, whereas no retrofenestral lesions were diagnosed in the 10 ears with mild-to-moderate hearing loss. The stapedial prostheses were adequately or very well reproduced by both methods.
CONCLUSION: CBCT is a new imaging technique with a considerably lower radiation dose than conventional MSCT. Our study indicates that CBCT is suitable and, in many ways, equivalent to MSCT, for temporal bone imaging in otosclerosis.
STUDY DESIGN: Prospective study.
PATIENTS: Twenty patients who underwent a stapedectomy 30 years ago were selected on the basis of bone conduction threshold values. Their mean age was 65 years (range, 48-76 yr).
INTERVENTION: All patients underwent CBCT and MSCT with a slice thickness of 0.5 to 0.6 mm.
MAIN OUTCOME MEASURES: Sixteen middle- and inner-ear anatomic structures and stapedial prostheses were analyzed by visual grading analysis. To assess critical reproduction and thereby the clinical applicability of CBCT, a dichotomization was made. Assessment of otosclerotic foci was performed using a grading system dividing the lesions in; (1) sole fenestral lesions, (2) retrofenestral lesions with or without fenestral lesions and (3) severe retrofenestral lesions.
RESULTS: The 16 anatomic structures were clearly reproduced by both imaging techniques. However, there was an interobserver variation in judging the superiority of 1 method in favor of the other. Otosclerotic lesions were diagnosed in 80/95% using MSCT and 50/85% using CBCT (evaluators 1 and 2, respectively). Retrofenestral lesions were diagnosed in 5 of 10 of ears with severe-to-profound hearing loss, whereas no retrofenestral lesions were diagnosed in the 10 ears with mild-to-moderate hearing loss. The stapedial prostheses were adequately or very well reproduced by both methods.
CONCLUSION: CBCT is a new imaging technique with a considerably lower radiation dose than conventional MSCT. Our study indicates that CBCT is suitable and, in many ways, equivalent to MSCT, for temporal bone imaging in otosclerosis.