Localized pericochlear hypoattenuating foci at temporal-bone thin-section CT in pediatric patients: nonpathologic differential diagnostic entity?
OBJECTIVE
To evaluate the prevalence of localized hypoattenuating areas in the cochlear otic capsule at temporal-bone thin-section computed tomography (CT) in pediatric patients and correlate the findings with clinical information.


METHODS
Temporal-bone thin-section CT images obtained in 73 patients aged 0-9 years (20 Austrian, 53 Finnish; 36 female and 37 male patients) were evaluated for the presence of localized hypoattenuating foci in the region of the fissula ante fenestram of the otic capsule. Clinical information collected for all patients was also evaluated. The data were analyzed with a logistic regression model.


RESULTS
Hypoattenuating areas in the region of the fissula ante fenestram were observed in 23 of 73 patients (32%). Hypoattenuating foci were substantially more prevalent in patients younger than 3 years than in those 3 years or older (odds ratio, 0.14; 95% CI: 0.04, 0.52; P =.001). The prevalence did not differ between sexes or according to clinical diagnosis. Only three of the 23 patients with hypoattenuating foci had clinical findings suggestive of otosclerosis, and none had osteogenesis imperfecta. After adjustment for age and sex, the finding was more prevalent among the Finnish patients (odds ratio, 5.4; 95% CI: 1.19, 24.52; P =.02) than among the Austrian patients.


CONCLUSIONS
Hypoattenuating areas in the region of the fissula ante fenestram in the otic capsule at thin-section CT are prevalent among children younger than 3 years in the absence of clinical evidence of otosclerosis or osteogenesis imperfecta and appear in children up to 9 years old.
Pekkola
Johanna
J
Departments of Radiology and Oto-Rhino-Laryngology, Helsinki University Hospital, Haartmaninkatu 4, POB 340, FIN-00029 HUS, Finland. johanna.pekkola@hus.fi
Pitkaranta
Anne
A
Jappel
Alexandra
A
Czerny
Christian
C
Baumgartner
Wolf-Dieter
WD
Heliovaara
Markku
M
Robinson
Soraya
S
D002648:Child; D002675:Child, Preschool; D015834:Cochlear Diseases / Q000000981:diagnostic imaging*; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008297:Male; D013701:Temporal Bone / Q000000981:diagnostic imaging*; D014057:Tomography, X-Ray Computed