Volume of mastoid pneumatization: three-dimensional reconstruction with ultrahigh-resolution computed tomography

The volume of the mastoid air cell system was measured in 69 patients with normal middle ears. All patients underwent axial ultrahigh-resolution computed tomography. Mastoid pneumatization was marked on each axial slice, and 3-dimensional reconstruction was performed. The volumes were measured with a volumetric algorithm. A polyethylene tubing phantom with a density similar to that of bone on computed tomography was devised. The polyethylene tubing was tied in a particular fashion so as to create interconnecting air spaces with a known volume. The phantom was scanned with the imaging parameters used for scanning the temporal bone. The air in the tubing was marked, and 3-dimensional reconstruction for the marked phantom air was performed. The volume of the interconnecting air spaces was measured and found to be identical to its known volume, thereby verifying the accuracy of the method used. The mean mastoid volume was 6.61 cm3. The smallest volume measured was 1.3 cm3, and the largest was 12.7 cm3. The importance of this technique lies in its high accuracy, ease of use, and ability to directly correlate mastoid size and clinical findings.