Usefulness of Three-Dimensional CT on Ossicular Lesions: A Report of 2 Cases

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  • ３Ｄ‐ＣＴが有用であった耳小骨病変の２例
  • リンショウ 3D CT ガ ユウヨウ デ アッタ ジショウコツ ビョウヘン ノ 2レイ

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Abstract

We experienced two cases of ossicular lesions in which three-dimensional (3D) images from multislice CT (MSCT) were useful in diagnosing the lesions. In the first case, the 3D images revealed an ossicular defect in the long process of the incus and the superstructure of the stapes in the middle ear. In the second case, discontinuity of the incudostapedial joint was revealed. The hearing level in both cases was improved by tympanoplasty. In the first case, besides the ossicular malformation, open-type congenital cholesteatoma was found in the middle ear during the operation. There is a possibility of residual recurrence of open-type cholesteatoma, so postoperative follow-up was necessary for the first case. Canal wall up tympanoplasty with posterior hypotympanotomy was performed in the second case. Since this procedure does not require managing the external auditory meatus or the tympanic membrane, it should be chosen in cases of normal tympanic membrane with traumatic ossicular chain discontinuity, such as the second case. In conclusion, reconstruction of 3D images by MSCT with 8 rows of detectors gave realistic and high-quality images of the ossicular lesions. The 3D images were useful for the surgeon's preoperative planning and for the patient's informed consent to the operation.

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