ORELHA MÉD. - LESÕES CONG. Flashcards
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COLESTEATOMA CONGÊNITO DA MASTOIDE
Axial T1WI C+ MR in the same patient shows both the lateral clival –> and
mastoid => components of a large temporal bone congenital cholesteatoma. As in this case, nonenhancement would be expected.
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ARTÉRIA CARÓDITA INTERNA LATERALIZADA
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ARTÉRIA CARÓDITA INTERNA ABERRANTE
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COLESTEATOMA CONGÊNITO DA OM
Axial T1WI C+ MR in the same patient reveals typical rim enhancement –> along the margins of this anterior epitympanic CMEC. The central nonenhancing component is the CMEC. Notice the more medial cochlear signal => .
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ARTÉRIA CARÓDITA INTERNA LATERALIZADA
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COLESTEATOMA CONGÊNITO DA MASTOIDE
Axial T2WI MR in the same patient reveals a giant temporal bone congenital mastoid cholesteatoma as a high signal sharply marginated mass –>.
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ARTÉRIA CARÓDITA INTERNA ABERRANTE
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PERSISTÊNCIA DA ARTÉRIA ESTAPEDIAL
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PERSISTÊNCIA DA ARTÉRIA ESTAPEDIAL
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COLESTEATOMA CONGÊNITO DA OM
Axial T2 MR in a 5-year-old boy previously operated on for CMEC reveals material in middle ear cavity –> and mastoid antrum =>. Differentiating postoperative changes from recurrent cholesteatoma is impossible in this image.
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ARTÉRIA CARÓDITA INTERNA ABERRANTE
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COLESTEATOMA CONGÊNITO DA MASTOIDE
Axial DWI MR in the same patient shows high signal –> in the location of the giant temporal bone congenital cholesteatoma. Restricted diffusion within the lesion is highly suggestive of the diagnosis of cholesteatoma.
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ATRESIA DA JANELA OVAL
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FÍSTULA PERILINFÁTICA
Axial bone CT in a 3-year-old child after fall on a coffee table shows a transverse T-bone fracture –> and pneumolabyrinth in the cochlea => and vestibule ~>. This child has persistent profound hearing loss without symptoms of vestibulopathy.
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ARTÉRIA CARÓDITA INTERNA LATERALIZADA
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COLESTEATOMA CONGÊNITO DA OM
Axial DWI in the same patient shows the mastoid collection with reduced diffusivity => indicating recurrent congenital cholesteatoma. Middle ear collection does not restrict –> and is not recurrent cholesteatoma.
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COLESTEATOMA CONGÊNITO DA MASTOIDE
Axial bone CT of the left ear demonstrates a round soft tissue mass (congenital mastoid cholesteatoma) centered in the lateral mastoid air cells. Note that the lateral cortex is dehiscent –> , and the sigmoid plate => is bowed medially.
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ARTÉRIA CARÓDITA INTERNA LATERALIZADA
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COLESTEATOMA CONGÊNITO DA OM
Axial bone CT of the right ear reveals a medial epitympanic congenital cholesteatoma –> eroding the medial head of the malleus => and short process of the incus ~> . Aditus ad antrum block causes mastoid effusion.
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COLESTEATOMA CONGÊNITO DA OM
Coronal bone CT in the same patient shows CMEC eroding the long process of the incus –> and filling the oval window niche =>. The tympanic segment of CNVII canal enlargement ~> is secondary to cholesteatoma focal invasion.
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ARTÉRIA CARÓDITA INTERNA ABERRANTE
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ANQUILOSE OSSICULAR CONGÊNITA
Axial bone CT shows a bony bar –> between the malleus head => and lateral epitympanic wall. Notice that there is no evidence of prior infection or trauma. The mastoid air cells are normally developed, and no inflammatory debris is present.
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PERSISTÊNCIA DA ARTÉRIA ESTAPEDIAL
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PERSISTÊNCIA DA ARTÉRIA ESTAPEDIAL
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ARTÉRIA CARÓTIDA INTERNA ABERRANTE
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COLESTEATOMA CONGÊNITO DA OM
Axial bone CT of the left ear reveals a CMEC in the anterior epitympanic recess scalloping the adjacent middle ear wall –> and bowing the epitympanic cog posteriorly =>. The malleus head abuts the posterior margin of the CMEC.
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COLESTEATOMA CONGÊNITO DA OM
Coronal bone CT in the same patient shows erosion of medial malleus head –> and lateral margin of anterior tympanic segment of CNVII canal => by this medial epitympanic CMEC.
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ARTÉRIA CARÓDITA INTERNA ABERRANTE
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ATRESIA DA JANELA OVAL
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ARTÉRIA CARÓDITA INTERNA ABERRANTE
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ANQUILOSE OSSICULAR CONGÊNITA
Coronal bone CT in the same patient shows a bony bar –> between the malleus head and lateral epitympanic wall. The external auditory canal is normal (not shown), and there is no evidence of previous infection.
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FÍSTULA PERILINFÁTICA
Axial bone CT in a 10-year-old boy, accidentally struck in the head by a baseball, depicts extensive pneumolabyrinth in cochlea, vestibule, and posterior semicircular canal –> , as well as pneumocephalus => . He was immediately dizzy, ataxic, and unable to hear out of left ear.
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FÍSTULA PERILINFÁTICA
Axial bone CT in a 14 year old imaged after a dirt bike accident shows a transverse T-bone fracture –> crossing the vestibule with pneumolabyrinth => in the vestibule and cochlea, as well as pneumocephalus ~>.
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COLESTEATOMA CONGÊNITO DA OM
Coronal temporal bone CT of the right ear demonstrates a large congenital cholesteatoma filling the middle ear cavity with subtle long process of incus and stapes hub erosion –> and deossification. The tympanic membrane bulges laterally but is intact by otoscopic examination.
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ATRESIA DA JANELA OVAL
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COLESTEATOMA CONGÊNITO DA OM
Axial bone CT of the right ear in a patient with recurrent otomastoiditis and conductive hearing loss reveals a soft tissue mass in the medial epitympanum eroding the medial surface of the head of the malleus & short process of the
incus –>.
The anterior tympanic CNVII canal is also dehiscent =>
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COLESTEATOMA CONGÊNITO DA MASTOIDE
Axial bone CT shows a multilobular congenital cholesteatoma involving the lateral clivus –> and the medial mastoid => . The expansile bony margins are suggestive of this diagnosis.
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ATRESIA DA JANELA OVAL
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COLESTEATOMA CONGÊNITO DA OM
Coronal graphic shows congenital middle ear cholesteatoma (CMEC). Notice that the lesion surrounds and is medial to the ossicles –>. The tympanic membrane is intact.
