Imaging of the Postoperative Middle Ear, Mastoid, and Internal Auditory Canal

Interpretation of CT or MR imaging examinations performed on patients with a history of middle ear, mastoid, or neurotologic surgery can be challenging. This is greatly simplified by knowing the surgical procedures used. Knowledge of the expected normal versus abnormal postoperative appearance is the key to recognizing complications or recurrent disease. This chapter initially discusses the surgical approaches to the middle ear and mastoid (transcanal, retroauricular, endaural) and the procedures facilitated by these (meatoplasty, canaloplasty, myringoplasty, tympanoplasty, ossiculoplasty, stapedectomy, mastoidectomy). Imaging findings indicative of recurrent disease are then discussed to include MR imaging for the detection of cholesteatoma. The chapter concludes with a discussion of surgical approaches to the internal auditory canal and otic capsule (retrosigmoid, middle cranial fossa, translabyrinthine, transmastoid) for the management of tumors and superior semicircular canal dehiscence.