The Cochlear Cleft: CT Correlation With Histopathology.

OBJECTIVE

To show the histologic correlate of the cochlear cleft, a small low density focus just anterior to the oval window seen on computed tomography (CT) in three temporal bone specimens.

PATIENTS

Three temporal bone specimens donated to the National Temporal Bone Registry from patients aged 34 weeks gestation, 42 years, and 89 years with cochlear clefts seen on CT were studied.

INTERVENTION

Review and comparison of postmortem high-resolution CT and temporal bone histopathology MAIN OUTCOME MEASURE:: Correlation of CT findings with temporal bone histopathology.

RESULTS

The cochlear cleft visible on CT as a pericochlear lucency anterior to the oval window corresponds to fatty marrow in areas of incomplete endochondral ossification of the otic capsule. The cochlear cleft is distinct from the fissula ante fenestram and can be present in adults.

CONCLUSION

In these three cases, the cochlear cleft represents an area of fatty marrow from incomplete ossification of the otic capsule and can be present in adults. Care should be taken when interpreting temporal bone CT to avoid mistaking the cochlear cleft for true pathology (otosclerosis) of the temporal bone.