Post-operative Temporal Bone Imaging

  • Luc van den Hauwe
  • Christoph Kenis
  • Bert De Foer
  • Jan Walther Casselman
Part of the Medical Radiology book series (MEDRAD)


Three categories of patients are referred for follow-up imaging after temporal bone surgery. The first group consists of patients with (complicated) chronic middle ear disease, including cholesteatoma. For this group, the imaging algorithm has changed enormously for the last 10 years. Multidetector computed tomography (MDCT) and more recently cone beam CT (CBCT) are ideally suited to demonstrate the bony details after mastoidectomy and to assess the integrity of the ossicular chain reconstruction when prosthetic failure is suspected. To evaluate the middle ear and/or mastoid cavity for the presence of residual cholesteatoma, MR imaging (MRI) has become the first choice diagnostic modality. Non-EPI diffusion-weighted imaging (DWI) has proven to be the most sensitive and specific technique and has higher diagnostic performance than delayed contrast-enhanced MR-imaging. After stapes surgery in patients with otosclerosis, imaging studies are rarely required. When prosthetic failure is suspected, MDCT and CBCT can be performed. In patients with postoperative vertigo and sensorineural hearing loss (SNHL), MR imaging may be needed to look for labyrinthine abnormalities (hemorrhage, infection, …) if CT is not contributive. In the follow-up of patients with vestibular schwannoma, MR imaging is the modality of choice, whether a conservative (‘wait and scan’) management, radiosurgery or surgey has been chosen.


Tympanic Membrane External Auditory Canal Cochlear Implant Magnetic Resonance Examination Internal Auditory Canal 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.



The author wishes to acknowledge his colleagues P.M. Parizel, MD, PhD, J.W. Van Goethem, MD, PhD and O. d’Archambeau, MD, Department of Radiology, Universitair Ziekenhuis Antwerpen—University of Antwerp for their kind readiness to share their imaging files. Thanks also to all colleagues of the Department of ENT Surgery (Chairman: P.H. Van de Heyning, MD, PhD), Universitair Ziekenhuis Antwerpen—University of Antwerp for their clinical input.


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© Springer-Verlag Berlin Heidelberg 2014

Authors and Affiliations

  • Luc van den Hauwe
    • 1
    • 2
  • Christoph Kenis
    • 3
  • Bert De Foer
    • 4
  • Jan Walther Casselman
    • 3
    • 4
    • 5
  1. 1.Department of RadiologyAZ KlinaBrasschaatBelgium
  2. 2.Department of RadiologyAntwerp University HospitalEdegemBelgium
  3. 3.Department of RadiologyAZ Sint Jan HospitalBruggeBelgium
  4. 4.Department of RadiologyGZA Sint Augustinus HospitalWilrijkBelgium
  5. 5.University of GhentGentBelgium

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