E1453. We Heard You! Simplifying Post-Surgical Temporal Bone
  1. Jason Hibbard; Froedtert Hospital; Medical College of Wisconsin
  2. Saivenkat Vagvala; Froedtert Hospital; Medical College of Wisconsin
  3. Nathan Gruenhagen; Froedtert Hospital; Medical College of Wisconsin
  4. Mokshal Porwal; Froedtert Hospital; Medical College of Wisconsin
  5. Mohit Agarwal; Froedtert Hospital; Medical College of Wisconsin
To establish a comprehensive approach to evaluate post-operative temporal bone and recognize its complications.

Educational Goals / Teaching Points
We will use appropriate cross-sectional CT and MRI images and diagrams to simplify temporal bone anatomy, discuss common temporal bone pathologies and describe the various surgical procedures performed to treat these pathologies. Using appropriate images, we will then discuss some post-surgical complications.

Key Anatomic/Physiologic Issues and Imaging Findings/Techniques
The trepidation of the prospect of interpreting the temporal bone is heightened by the history of a previous surgical procedure. Many different surgical approaches are used to treat temporal bone pathologies and to restore hearing in middle and inner ear disease. A variety of mastoidectomy types and partial (PORP) and total (TORP) ossicular replacement prostheses are in practice. Several different autografts are also used, such as cartilage graft for tympanic membrane reconstruction and incus interposition graft for ossicular chain reconstruction. The knowledge of the spectrum of these surgical procedures is essential for meaningful and utilizable reporting of the post-surgical temporal bone. In this exhibit, we will systematically describe these procedures and their imaging appearances and also discuss post-surgical complications.

Interpretation of post-operative temporal bone is challenging. Knowledge of the surgical procedures can help in identifying failed surgeries and post-surgical complications and empower radiologists.