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European Radiology

, Volume 24, Issue 3, pp 587–594 | Cite as

Clinical investigation of flat panel CT following middle ear reconstruction: a study of 107 patients

  • K. ZaouiEmail author
  • J. Kromeier
  • M. Neudert
  • T. Beleites
  • T. Zahnert
  • R. Laszig
  • C. Offergeld
Head and Neck

Abstract

Objectives

After middle ear reconstruction using partial or total ossicular replacement prostheses (PORP/TORP), an air–bone gap (ABG) may persist because of prosthesis displacement or malposition. So far, CT of the temporal bone has played the main role in the diagnosis of reasons for postoperative insufficient ABG improvement. Recent experimental and clinical studies have evaluated flat panel CT (fpCT) as an alternative imaging technique that provides images with high isovolumetric resolution, fewer metal-induced artefacts and lower irradiation doses.

Methods

One hundred and seven consecutive patients with chronic otitis media with or without cholesteatoma underwent reconstruction by PORP (n = 52) or TORP (n = 55). All subjects underwent preoperative and postoperative audiometric testing and postoperative fpCT.

Results

Statistical evaluation of all 107 patients as well as the sole sub-assembly groups (PORP or TORP) showed a highly significant correlation between hearing improvement and fpCT-determined prosthesis position. FpCT enables detailed postoperative information on patients with middle ear reconstruction.

Conclusions

FpCT is a new imaging technique that provides immediate feedback on surgical results after reconstructive middle ear surgery. Specific parameters evaluated by fpCT may serve as a predictive tool for estimated postoperative hearing improvement. Therefore this imaging technique is suitable for postoperative quality control in reconstructive middle ear surgery.

Key Points

Flat panel CT offers advantages with regard to artefacts and radiation dose.

FpCT provides higher isovolumetric resolution of temporal bone and middle ear implants.

FpCT allows prediction of the postoperative hearing outcome in patients.

FpCT is an important tool for immediate postoperative quality control.

FpCT improves postoperative management of patients with complications following ossicular replacement

Keywords

Ossicular replacement prostheses PORP TORP Flat panel CT Imaging Middle ear Quality control 

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Copyright information

© European Society of Radiology 2013

Authors and Affiliations

  • K. Zaoui
    • 1
    Email author
  • J. Kromeier
    • 3
  • M. Neudert
    • 4
  • T. Beleites
    • 4
  • T. Zahnert
    • 4
  • R. Laszig
    • 2
  • C. Offergeld
    • 2
  1. 1.Department of Otorhinolaryngology, Head and Neck SurgeryUniversity Hospital Heidelberg, Ruprecht Karls UniversityHeidelbergGermany
  2. 2.Department of Otorhinolaryngology, Head and Neck SurgeryUniversity Hospital Freiburg, Albert Ludwigs UniversityFreiburgGermany
  3. 3.Department of RadiologySt. Josefs Hospital, RkKFreiburgGermany
  4. 4.Department of Otorhinolaryngology, Head and Neck SurgeryUniversity Hospital Dresden, Technical UniversityDresdenGermany

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