Mastoiditis CT: Difference between revisions

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[[High Resolution CT]] scans of the [[temporal bone]] in mastoiditis patients may reveal complications, such as the following: <ref name="pmid19734439">{{cite journal |vauthors=Lin HW, Shargorodsky J, Gopen Q |title=Clinical strategies for the management of acute mastoiditis in the pediatric population |journal=Clin Pediatr (Phila) |volume=49 |issue=2 |pages=110–5 |year=2010 |pmid=19734439 |doi=10.1177/0009922809344349 |url=}}</ref><ref name="pmid17668240">{{cite journal |vauthors=Stähelin-Massik J, Podvinec M, Jakscha J, Rüst ON, Greisser J, Moschopulos M, Gnehm HE |title=Mastoiditis in children: a prospective, observational study comparing clinical presentation, microbiology, computed tomography, surgical findings and histology |journal=Eur. J. Pediatr. |volume=167 |issue=5 |pages=541–8 |year=2008 |pmid=17668240 |doi=10.1007/s00431-007-0549-1 |url=}}</ref><ref name="pmid22695997">{{cite journal |vauthors=Trojanowska A, Drop A, Trojanowski P, Rosińska-Bogusiewicz K, Klatka J, Bobek-Billewicz B |title=External and middle ear diseases: radiological diagnosis based on clinical signs and symptoms |journal=Insights Imaging |volume=3 |issue=1 |pages=33–48 |year=2012 |pmid=22695997 |pmc=3292638 |doi=10.1007/s13244-011-0126-z |url=}}</ref>
[[High Resolution CT]] scans of the [[temporal bone]] in mastoiditis patients may reveal complications, such as the following: <ref name="pmid19734439">{{cite journal |vauthors=Lin HW, Shargorodsky J, Gopen Q |title=Clinical strategies for the management of acute mastoiditis in the pediatric population |journal=Clin Pediatr (Phila) |volume=49 |issue=2 |pages=110–5 |year=2010 |pmid=19734439 |doi=10.1177/0009922809344349 |url=}}</ref><ref name="pmid17668240">{{cite journal |vauthors=Stähelin-Massik J, Podvinec M, Jakscha J, Rüst ON, Greisser J, Moschopulos M, Gnehm HE |title=Mastoiditis in children: a prospective, observational study comparing clinical presentation, microbiology, computed tomography, surgical findings and histology |journal=Eur. J. Pediatr. |volume=167 |issue=5 |pages=541–8 |year=2008 |pmid=17668240 |doi=10.1007/s00431-007-0549-1 |url=}}</ref><ref name="pmid22695997">{{cite journal |vauthors=Trojanowska A, Drop A, Trojanowski P, Rosińska-Bogusiewicz K, Klatka J, Bobek-Billewicz B |title=External and middle ear diseases: radiological diagnosis based on clinical signs and symptoms |journal=Insights Imaging |volume=3 |issue=1 |pages=33–48 |year=2012 |pmid=22695997 |pmc=3292638 |doi=10.1007/s13244-011-0126-z |url=}}</ref>
* Acute mastoiditis: Findings include [[mastoid]] [[septation]] and [[cortex]] erosion.
●Fluid and/or mucosal thickening in the middle ear and mastoid (clouding); this is a nonspecific finding As an isolated finding, clouding of the mastoid does not indicate mastoiditis [49].
●Loss of definition of the bony septae that define the mastoid air cells (coalescent mastoiditis (image 1)); this finding is diagnostic of mastoiditis.
●Destruction or irregularity of the mastoid cortex (image 2).
●Periosteal thickening, disruption of the periosteum, subperiosteal abscess
•partial-to-complete opacification of the mastoid air cells, sometimes of the middle ear cleft as well
•erosion of mastoid air cell bony septum may be present in coalescent mastoiditis
Chronic
The term encompasses a number of conditions:
• tympanic membrane changes: thickening, retraction, tympanic membrane perforation or calcification (myringosclerosis)
• mastoid process changes: underdeveloped pneumatisation, sclerosis or opacification
• middle ear changes:◦ middle ear atelectasis/ effusion/ granulation tissue
◦noncholesteatomatosis ossicular chain and tympanic cavity erosions
◦ossicular chain fixation
◦tympanosclerosis
◦acquired cholesteatoma
◦cholesterol granuloma


=== Acute mastoiditis ===
*Partial-to-complete opacification of mastoid air cells due to fluid accumulation and thickening of the mucosa that lines the middle ear.
*Erosion of mastoid air cell bony septum
*Mastoid cortex destruction and irregularity
*Periosteal thickening, periosteal disruption,
*subperiosteal abscess.


=== Sub acute and chronic mastoiditis ===
Primary imaging findings for chronic mastoiditis include the following:
* Markers for [[inflammation]].
* Sclerosis or opacification of mastoid process
* Tympanic membrane changes: thickening, retraction, tympanic membrane perforation or calcification
* Ossicle erosion or other possible causes for [[hearing loss]].
* Determination of [[cholesteatoma]].
* Intratemporal complications: petrositis, [[labyrinthitis]], [[subperiosteal]] [[abscess]], labyrinthine [[fistula]]
* Intracranial complications: [[brain abscess]], [[meningitis]]
* Presence of [[fibrous]] [[tissue]].
* Tympanosclerosis.
* Formation of new bone matter.
* [[Ossicles|Ossicle]] erosion and displacement.
* Extension of [[cholesteatoma]] to [[sinuses]]


==References==
==References==

Revision as of 16:33, 28 June 2017

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Mehrian Jafarizade, M.D [2]

Overview

CT

High Resolution CT scans of the temporal bone in mastoiditis patients may reveal complications, such as the following: [1][2][3]

Acute mastoiditis

  • Partial-to-complete opacification of mastoid air cells due to fluid accumulation and thickening of the mucosa that lines the middle ear.
  • Erosion of mastoid air cell bony septum
  • Mastoid cortex destruction and irregularity
  • Periosteal thickening, periosteal disruption,
  • subperiosteal abscess.

Sub acute and chronic mastoiditis

Primary imaging findings for chronic mastoiditis include the following:

References

  1. Lin HW, Shargorodsky J, Gopen Q (2010). "Clinical strategies for the management of acute mastoiditis in the pediatric population". Clin Pediatr (Phila). 49 (2): 110–5. doi:10.1177/0009922809344349. PMID 19734439.
  2. Stähelin-Massik J, Podvinec M, Jakscha J, Rüst ON, Greisser J, Moschopulos M, Gnehm HE (2008). "Mastoiditis in children: a prospective, observational study comparing clinical presentation, microbiology, computed tomography, surgical findings and histology". Eur. J. Pediatr. 167 (5): 541–8. doi:10.1007/s00431-007-0549-1. PMID 17668240.
  3. Trojanowska A, Drop A, Trojanowski P, Rosińska-Bogusiewicz K, Klatka J, Bobek-Billewicz B (2012). "External and middle ear diseases: radiological diagnosis based on clinical signs and symptoms". Insights Imaging. 3 (1): 33–48. doi:10.1007/s13244-011-0126-z. PMC 3292638. PMID 22695997.

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