A case of traumatic disruption of the ossicular chain detected with reconstruction techniques multiplanar and three-dimensional computed tomography

High-resolution computed tomography (CT) demonstrates the osseous structures of the temporal bone, and is particularly useful for diagnosis of middle ear diseases leading to conductive hearing loss. The axial and coronal section planes are commonly used for a conventional CT diagnosis of the temporal bone. In recent years, oblique section plane reformatted by high-resolution multiplanar reconstruction (MPR) CT images and three-dimensional (3D) CT images have allowed more detailed examinations of the ossicular chain. The creation of additional MPR images and 3D reconstruction images from the original CT data set can help overcome the limitations of conventional CT images by providing a more anatomically meaningful display of complex structures in the temporal bones. We report herein on the MPR-CT and 3D-CT findings of a case of traumatic ossicular chain disruption. A 27-year-old female had fractures of the cranial base, temporal bone, mandible, zygomatic bone, and optic canal sustained as the result of a traffic accident. She also had tinnitus and hearing loss in her right ear, and was referred to the Department of Otolaryngology. Her tympanic membranes were intact, and audiological examination revealed severe conductive hearing impairment in the right side. Conventional axial and coronal CT images showed no remarkable findings without temporal bone fracture, and the diagnosis of ossicular chain disruption was confirmed by intraoperative findings. We performed a type III-i tympanoplasty, and both conductive hearing loss and tinnitus improved. MPR-CT images and 3D reconstruction CT images showed the disruption in the ossicular chain. In conclusion, recent developments of image-processing technologies including MPR and 3D reconstruction provide a better understanding of middle ear diseases.