Ultra-high-resolution CT of the temporal bone: Technical aspects, current applications and future directions

Temporal bone imaging has historically suffered from spatial resolution issues because the spatial resolution of conventional high-resolution computed tomography (CT) is 0.5 mm, while the smallest structure of the middle ear, the stapes, has very thin components, as thin as 0.19 mm, and small structures, such as small channels containing nerves and arteries, have historically been beyond its spatial resolution. Photon-counting and ultra-high resolution CT allow for improved spatial resolution and reduced radiation dose compared to conventional high-resolution CT. This article provides a technical approach to understanding the technical aspects of these new techniques and an updated description of the middle and inner ear, as well as a practical approach to understanding the normal and pathologic anatomy of the temporal bone in the light of ultra-high resolution imaging techniques.