[Virtual otoscopy of middle ear structure and pathology]

To assess the value of high-resolution CT data of the temporal bone for the virtual endoscopic (VE) visualization of the ossicular chain and the temporal bone.

Fifty patients with suspected lesions of middle ear underwent a high-resolution CT of the temporal bone with VE, seventeen patients were subsequently operated. CT examinations of the temporal bone were carried out using spiral equipment and endoscopic 3D processing was carried out on a separate workstation equipped with a flying through program.

VE is valuable for the evaluation of ossicular dislocation, disruption and ossicular lysis, morphological anomalies of the malleus, incus, and stapes, as well as for evaluation of normal middle ear structures with high detail. The VE assessment in detecting ossicular disruption of chronic otitis media match the operation exploration perfectly (10 in 11 ears), whereas only 3 in 6 ears of cholesteatoma match the operation exploration.

This image processing method can be used pre-operatively for the individual planning, simulation, and post-operatively for assessment of the position of implants.