Quality management in middle ear surgery: controversies regarding preoperative imaging

Today a large variety of different imaging techniques are available for middle ear investigation. However, imaging is not suitable to give essential information in every case on the surgical strategy to be chosen. This article discusses the most frequent indications for preoperative imaging and the relevant techniques. CT scanning, MRI and rotational tomography are taken into consideration as well as traditional X-ray investigations like e.g. 'Schüller's view'. In general, preoperative imaging should only be performed in a patient if certain specific questions can be answered. The experience of the investigator to interpret the images may influence the choice of imaging as well as the equipment he has access to.