X-ray analysis of mastoiditis

Radiography of the temporal bone in Cullera is the most appropriate method of roentgenologic examination of its mastoid part. X-ray detection of bone destructive changes in the initial phase of mastoiditis requires high technical quality radiographs.
To simplify complex equipment of pictures of the temporal bone is recommended modification of the Century, Ginzburg, simplifying radiography on Scullery and Mayer.
X-ray picture of primary, exudative, forms of mastoiditis is characterized by darkening cells; symptoms of bone destruction are missing. In the next phase of mastoiditis on the x-ray detected a significant loss in the intensity of the shadows of the walls of cells, sometimes almost complete absence of the image, which is explained by the bone resorption process. Purulent fusion walls of cells with the formation of an abscess in the mastoid process is determined radiographically as the source of depression. This symptom secondary enlightenment occurs despite the presence in the abscess cavity of purulent fluid, due to the destruction of bone tissue, absorbing the rays (Fig. 1).
The focus of bone destruction can have some time trabecular structure because of the remaining cells, those around the abscess cavity. Tomography of the temporal bone allows to detect in this phase ulcer. When education subperiosteal abscess with the complete destruction of the bones occurs intensive homogeneous enlightenment (Fig. 2 and 3). Large solitary cell in the mastoid process is a relatively rare anatomical option (Fig. 4 and 5) with acute otitis media may lead to wrong screening mastoiditis, especially its latent form, with the poor by the cells of the mastoid process. Cavity such cells mistaken even for cholesteatoma (Fig. 6)penetrated into the mastoid process. The presence parenteralnyh cells indicates anatomical option, but not on the ear cholesteatoma, always with a built cholesteatomas cavity in antrame.
To detect darkened parenteralnyh cells and cholesteatomas cavity in the field of antrum use the projection Mayer. Cavity subperiosteal abscess if it is not formed from several large cells (Fig. 7), as a rule, has no real shape, typical of the cholesteatoma. Apical mastoiditis (abscess of Bezold) may not be detected if it is limited to only one projection of Cullera. Radiograph in Stenvers allows you discover a defect internal cortical plate mastoid process (Fig. 8-10).
Conservative treatment of surgical forms of mastoiditis with a favorable course leads to a complete bone regeneration on the site of the abscess and to restore the lightness of the remaining cells, and mastoid air is Mixed (Fig. 11 and 12).

radiograph of the temporal bone
Fig. 1. Radiograph of the temporal bone in Cullera; acute mastoiditis; cell is dark, large destructive hearth in the mastoid bone (the secondary symptom of enlightenment).

Fig. 2. Acute mastoiditis, huge bone defect in the mastoid process; subperiosteal abscess (right temporal bone). Fig. 3. The left temporal bone (norm) - comparative radiograph.
mastoiditis roentgen
Fig. 4 and 5. X-rays are normal temporal bone (Fig. 4 - a projection of Cullera; Fig. 5 - oblique projection of the mastoid process on Stenvers). Large solitary cell on the top of the mastoid process with a thin line of shadow path. Fig. 6. The cavity of cholesteatoma on top of the ridge with a thin line of shadow contour; cells are missing (projection of Cullera).
acute mastoiditis x-ray
Fig. 7. A large cavity subperiosteal abscess (acute mastoiditis), formed of several cells (projection of Cullera). Fig. 8-10. Left apical mastoiditis (abscess of Bezold): Fig. 8 - cell abruptly darkened, the top of the mastoid compact structure: Fig. 9 - visible cells elite, inner and outer cortical plate thin; Fig. 10 - full visible defect internal cortical plate tops (arrow), outer cortical plate considerable thickness. Fig. 11 and 12. Projection of Cullera; acute mastoiditis, conservative treatment: Fig. 11 - bone-pneumatic type, the beginning of the disease, the cells of the temporal bone is dark, on top of the ridge is visible destructive focus (secondary symptom of enlightenment): Fig. 12 - stage treatment, full recovery of lightness cells of the temporal bone, reparative bone changes on the former site of the lesion in the mastoid bone.