The lacrimo-auriculo-dento-digital (LADD) syndrome is a rare inherited disorder affecting the lacrimal, auricular, salivary, and osseous system. Only very limited data on LADD associated petrous bone lesions are available up to now. We describe a young girl suffering from the LADD syndrome with sensorineural hearing loss and inner ear dysplasia. This case suggests, that inner ear dysplasia might be a more common feature of the LADD syndrome than has been assumed so far.

MSCT data sets allow for generating virtual endoscopic views closely resembling otoendoscopic images. The technique is especially useful when ossicular pathologic changes are present as well as for preoperative and postoperative imaging of otologic procedures.

Multi-slice computerized tomography (MSCT) is considered to provide superior image quality. We defined a data acquisition protocol for high-resolution (HR) temporal bone imaging using MSCT and assessed its impact on data acquisition and post-processing (PP). The data acquisition protocol was defined in cadaveric phantom studies performed by MSCT and subsequently applied to 38 patients referred for temporal bone assessment. The parameters image quality and diagnostic value of MSCT data were assessed for the cross-sectional source images as well as for 2-dimensional (2D) reformations and 3-dimensional (3D) reconstructions by 3 radiologists by comparison with incremental HR scans of 17 patients with suspected middle ear disorders. The data acquisition protocol yielded HR images with an excellent detail resolution and a comparable image quality of cross-sectional scans and related orthogonal reformations. MSCT achieved higher scores for image quality and diagnostic value (p < 0.001, t-test) than incremental HR CT with regard to both 2D and 3D reconstructions. MSCT improves the image quality of HR cross-sectional scans as well as that of 2D and 3D PP techniques in petrous bone imaging. The radiation exposure of the eye lenses is increased by MSCT as gantry angulation is not yet possible in the helical scan mode.

ABR recordings were made on 31 normal-hearing subjects and 253 patients with sensorineural hearing loss (86 patients with unilateral hearing loss, 61 patients with asymmetrical hearing loss, 34 patients with symmetrical hearing loss, 55 patients with noise-induced hearing loss and 17 patients in the late chronic stage of Menière's disease). In the patient group with unilateral hearing loss, the mean interpeak interval (IPI) I-V was significantly shorter than in normal-hearing subjects. The interaural IPI differences provide a sharp criterion for early detection of acoustic neuroma. The calculation of the 95%-limits (means + 1.96 SD) showed that in patients with normal hearing or with unilateral or symmetrical hearing loss an interaural difference in the IPII-V greater than 0.2 ms has to be considered as an indication of a neuroma or any other brainstem abnormality. In patients with asymmetrical or with noise-induced hearing loss, the limit is 0.3 ms. In contrast to the frequently recommended interaural wave V latency difference criterion, the interaural IPI difference criterion requires no correction for audiogram differences.

The imaging protocol allows for rapid and comprehensive visualization of various IE dysplasias, based on a limited number of VR reconstructions.

Virtual endoscopy allows for the non invasive endoluminal visualization of various tympanic lesions. Use of the multi-slice CT technique reduces the scanning time and improves image quality in terms of detail resolution.

Volume rendering is the postprocessing technique of choice for 3-dimensional inner ear visualization, performing better than maximum-intensity projections with respect to various parameters.

MSCT imaging of the temporal bone allows for comprehensively assessing various dysplasias through high-quality two-dimensional and three-dimensional image reconstructions.