Introduction:
Imaging of lateral skull base before operation is daily routine and recommended by
current guidelines. Nevertheless, precision and relevance of visualization of dedicated
structures of the lateral skull base under pathological conditions is still under
discussion.
Methods:
Results of preoperative imaging of 85 patients by CBCT were compared to intraoperative
findings. Imaging was performed in clinical suspicion of chronic otitis media adhesive
or meso-/epitympanalis. 79 different anatomic and radiological parameters were analyzed.
Results:
In most of the structures (e.g. bony skull base, semicircular canals, long process
of incus) a significant correlation of imaging and intra-op findings was detected
(p < 0.01). Only in visualisation of incu-stapedial joint, the parts of the stapes
and the tympanic part of facial nerve, a low or no correlation could be found. Subgroups
analysis of different pathologies showed most impairments in cholesteatoma. In patients
with chronic otitis media mesotympanalis only the visualisation of the ear drum was
limited.
Conclusion:
CBCT realizes a sufficient visualization of relevant anatomic bony structures of lateral
skull base. Regarding the stapes, significant limits exist and a sufficient differentiation
of underlying pathology, bony destruction and anatomic variant is still not possible.
