Clinical Feasibility of Multiplanar Reconstruction Images of Temporal Bone CT in the Diagnosis of Temporal Bone Fracture with Otic-Capsule-Sparing Facial Nerve Paralysis

Abstract

The aim of this study is to evaluate the feasibility of multiplanar reconstructive (MPR) imaging of temporal bone CT in the diagnosis of temporal bone fracture with oticcapsule-sparing facial nerve paralysis. Twelve patients with traumatic facial nerve paralysis with oticcapsule sparing and temporal bone fractures were selected. Multiplanar reconstruction images were obtained with the V-works 4.0 software program (Cybermed, Seoul, Korea) using axial scanning of high-resolution temporal bone CT of the fracture line. The clinical profiles of the patients displaying temporal bone fractures were examined in relation to the findings. Multiplanar images of the fracture line provided information regarding the direction of the external force that fractured the temporal bone. The fracture line was more continuous in the MPR images than in the axial view. All patients showed an imaginary extended fracture line directed toward the otic capsule. The direction of the fracture line toward the middle ear cavity is important, as it may suggest insult to the otic capsule. The MPR image parallel to the fracture line of the temporal bone provides a guideline for the vector of the force that induced the fracture. Thorough investigation of the critical organs during surgical exploration is recommended if the direction of the fracture in the MPR image points toward the otic capsule in the middle ear even if the fracture line relative to the otic capsule is not well defined in the axial or CT view.

Clinical features and radiological evaluation of otic capsule sparing temporal bone fractures

“…In our previous study using multiplanar reconstruction images of temporal bone CT, 12 cases of traumatic facial paralysis among those with otic capsule sparing temporal bone fractures were observed with images of the fracture line in which the extension was estimated to approach the otic capsule 9 …”

“…, 8 Mild symptoms and complications of temporal bone fractures are expected in the otic capsule sparing group, which covers most types of temporal bone fracture. However, more systematic research is required to investigate this category because such fractures can exhibit a variety of neurological symptoms, including facial paralysis 9 …”

Application of Computed Tomography Processed by Picture Archiving and Communication Systems in the Diagnosis of Acute Achilles Tendon Rupture

“…You can also adjust the axis to vertical or horizontal to the tibia, tendons, or other tissues to reduce the position requirements for CT scan. More details of the damage can also be learned from the different levels [9]. We can observe the continuity and tension of AT in 3DVR and MPR images and get a CT diagnosis.…”

Which temporal bone anatomical structures and pathologies could be best visualized by applying reconstruction to cross-sections obtained on an axial plane?

“…The serial oblique images were acquired rectangularly to a fracture line with 0.5-mm intervals in the axial temporal bone scan. [31] Zhou et al in 2014 evaluated the oblique axial and coronal planes, on which the tympanic bone remnant was shown, and the ossicular mass appeared to be the largest in size. HRCT evaluation using MPR provided significant benefits.…”