CT findings in temporal bone osteoradionecrosis.
OBJECTIVE
The goal of this study was to describe computed tomographic findings in patients with clinically proven temporal bone (TB) osteoradionecrosis (ORN) (TB-ORN).


METHODS
Computed tomographic scans of 20 patients were retrospectively evaluated for bony and soft tissue abnormalities. Clinical severity was graded based on level of therapy administered: mild (observation), moderate (antibiotics/hyperbaric oxygen), or severe (surgery).


RESULTS
Radiation dose to the primary tumor ranged from 30 to 75.6 Gy. Time to onset of ORN from completion of radiation therapy was 2 to 22 years (median, 7 years).


RESULTS
exposed bone, 20 of the 20 patients; otorrhea, 17 of the 20 patients; hearing loss, 11 of the 20 patients; otalgia, 10 of the 20 patients; facial nerve paralysis, 2 of the 20 patients; gait imbalance, 2 of the 20 patients. Computed tomographic findings: external auditory canal erosions, 18 of the 20 patients; mastoid effusion, 18 of the 20 patients; mastoid bony coalescence, 5 of the 20 patients; enhancing soft tissue, 6 of the 20 patients; soft tissue gas, 6 of the 20 patients; temporomandibular joint/condylar erosion, 3 of the 20 patients.Three patients developed an abscess.


CONCLUSIONS
Mastoid effusion and external auditory canal erosions are commonly seen with TB-ORN. Clinically moderate or severe cases of TB-ORN are more likely to demonstrate enhancing soft tissue (P = 0.002), soft tissue gas (P = 0.002), and temporomandibular joint involvement (P = 0.07).
From the *Department of Diagnostic Radiology, University of Texas MD Anderson Cancer Center, Houston, TX; †Department of Diagnostic and Interventional Imaging, The University of Texas Medical School at Houston, Houston, TX; ‡Department of Radiation Oncology, and §Department of Head and Neck Surgery, University of Texas MD Anderson Cancer Center, Houston, TX.
Salmaan
S
Ahmed
Nakul
N
Gupta
Jackson D
JD
Hamilton
Adam S
AS
Garden
Paul W
PW
Gidley
Lawrence E
LE
Ginsberg
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001847:Bone Diseases / Q000000981:diagnostic imaging* / Q000209:etiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010025:Osteoradionecrosis / Q000000981:diagnostic imaging* / Q000209:etiology*; D020266:Radiotherapy, Conformal / Q000009:adverse effects*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013701:Temporal Bone / Q000000981:diagnostic imaging* / Q000528:radiation effects; D014057:Tomography, X-Ray Computed / Q000379:methods*