Published February 16, 2022
Richard Wiggins, MD
Associate Dean of CME
Professor of Radiology and Imaging Sciences
University of Utah Health Science Center
The temporal bone (TB) is a complex structure within the lateral skull base, often with difficult pathologies, including a wide range of congenital, infectious, inflammatory, vascular, and neoplastic processes. To correctly evaluate TB imaging, it is critical to understand TB anatomy—and then, how to use logic and rationality to objectively evaluate cross-sectional imaging findings of the TB. The correlation between clinical presentation and physical examination findings significantly alters TB imaging interpretation. Also, CT and MRI are complementary imaging modalities for evaluating TB abnormalities.
On Friday, March 4, 2022, “Temporal Bone Imaging Made Easy: Basic to Advanced (Everything You Ever Wanted to Know, But Were Afraid to Ask)” will offer imaging professionals a unique opportunity to interact with a diversity of expert head and neck radiologists from across North America. Relevant for a broad audience—practicing head and neck radiologists, neuroradiologists, otolaryngologists, neurologists, as well as allied residents and fellows—this ARRS Virtual Symposium offers up to 4 CME and 4 SA-CME credits during and after the live event, through March 3, 2023.
The symposium will begin with a complete review of TB anatomy (Fig. 1), care of Dr. Laura Eisenmenger from the University of Wisconsin School of Medicine, followed by an examination of the facial nerve by Dr. Luke Ledbetter from UCLA’s David Geffen School of Medicine.
Next, we will address the critical anatomy and pathology leading to both conductive hearing loss (CHL) and sensorineural hearing loss (SNHL) from Dr. Blair Winegar at the University of Utah Health Science Center and Dr. Kalen Riley from Indiana University Health, respectively. When imaging a patient with hearing loss, the clinical examination does not always include an accurate history of the hearing loss itself (unilateral, bilateral, slow or fast onset, conductive, sensorineural, or mixed) or the patient’s medical history, which may be significant. In general, we want to begin a CHL case using CT with focused imaging of the inner ear, middle ear, and external auditory canal, whereas an SNHL case may begin with MRI focusing on the inner ear, internal auditory canal, and cerebellopontine angle.
Following the break, Dr. Remy Lobo from University of Michigan Medicine will review imaging findings of pulsatile tinnitus pathologies. Infectious and Inflammatory processes of the TB will then be discussed by Dr. Nick Koontz from Indiana University School of Medicine. Thin-section CT and MRI provide complementary information in evaluating these TB pathologies (Fig. 2).
I will then analyze complex postoperative imaging findings of TB cases, pointing out key details for consideration. And for the final lecture, Dr. Kelly Dahlstrom from University of Kansas Health Systems will present interactive cases reviewing the top points from all our earlier presentations. As we will do before the break, we’ll end the symposium with another Q&A session, allowing faculty to address individual questions, comments, and concerns.
A thorough understanding of the TB’s anatomical complexities and cross-sectional imaging of pathologies can facilitate expert interpretation of these difficult cases. Because clinical presentation and physical examination findings can significantly change our interpretation of TB imaging studies, communication with referring health care providers is crucial to providing the best patient care.
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