"Transcanal view" computed tomography reformat: Applications for transcanal endoscopic ear surgery

Area of Science:

• Otolaryngology
• Medical Imaging
• Surgical Planning

Background:

• Transcanal endoscopic ear surgery (TEES) is a minimally invasive approach for otologic procedures.
• A lack of en face preoperative imaging hinders detailed surgical planning for TEES.

Purpose of the Study:

• To assess the utility of a novel transcanal high-resolution computed tomography (HRCT) reformat for preoperative planning in TEES.
• To evaluate if this imaging technique can effectively visualize middle ear pathologies and anatomy.

Main Methods:

• Preoperative HRCTs from patients with middle ear pathologies (cholesteatoma, otosclerosis, glomus tympanicum) undergoing TEES were analyzed.
• Axial HRCT images were rotated and reformatted to create a transcanal view, aligning with the external auditory canal plane.
• The reformatted images were reviewed to identify critical anatomy and pathology in correlation with TEES findings.

Main Results:

• A transcanal HRCT reformat was successfully created, providing an en face perspective.
• The imaging accurately identified cholesteatoma involvement, eroded ossicles, otosclerotic lesions, and vascular structures like the facial nerve and jugular bulb.
• Quantitative measurements of middle ear structures were recorded.

Conclusions:

• The transcanal HRCT reformat shows promise as an aid for preoperative planning in TEES.
• This novel imaging approach can highlight patient-specific anatomy and pathology, potentially improving surgical precision.