Abstract
P086
Objectives: The goal of this study was to investigate the advantages of the three-dimensional (3-D) reconstruction of temporal bone during middle ear surgery and also its application to PACS (Picture Archiving and Communication System).
Methods: 3-D images of 2 cases were reconstructed from spiral high-resolution temporal bone CT. One was a case of recurrent chronic otitis media with cholesteatoma that needed a revisional modified radical mastoidectomy, and the other case was of chronic otitis media with high jugular bulb. 3-D reconstruction was performed by segmentation, and surface-rendering algorithm on a personal computer. As this computer was linked to PACS (m-view 5.0, marotech, Korea) of the hospital, image data from spiral high resolution CT were directly downloaded from PACS and reconstructed images were then saved to PACS. A software (Vwork 4.0, Cyber-Medtm, Korea) was used for image reconstruction.
Results: We were able to demonstrate the 3-D display of status of middle ear and mastoid, as well as various structures in them. We could focus on the relationship of high facial ridge and underlying facial nerve, especially helpful in cases of revisional modified radical mastoidectomy, and in cases of high jugular bulb, we could estimate the extent of high jugular bulb to middle ear space on the monitor in operation room. Computer-assisted measurement of reconstructed structures demonstrated comprehensively the anatomic details, improved surgeon's understanding of their spatial relationship, and so, was helpful for surgery itself and for preventing unexpected complications.
Conclusion: The 3-D reconstruction of temporal bone CT associated with PACS can be useful for anatomical understanding of temporal bone and also help to avoid an iatrogenic complication by monitoring during surgery.