Temporal bone disease: a comparison between high resolution computed tomography and pluridirectional tomography.

Sixty-five patients with suspected ear disease were examined with CT, and abnormalities were detected in 42 of them; 58 of these patients also had pluridirectional tomographic examinations. Eighteen of the patients in whom abnormalities were detected underwent exploratory surgery. CT was useful in the diagnosis of tympanic membrane swelling, fluid in the middle ear, cholesteatoma, granulation tissue, and adhesions. The superior contrast resolution of CT allowed for the visualization of ossicles when they were surrounded by an inflammatory mass or by blood. In trauma cases, axial images facilitated visualization of longitudinal fractures, which frequently pass through the geniculate ganglion of the facial nerve. CT and pluridirectional tomography were comparable in the demonstration of disease that involved the mastoid air cells, although fluid in air cells was more easily demonstrated by CT. Pluridirectional tomography was superior to CT in the demonstration of bone destruction; CT, however, was more sensitive in the diagnosis of lateral semicircular canal fistula. Based on this analysis, we recommend that these two modalities be used in a complementary fashion to evaluate suspected middle ear disease.