Interpretation of Computed Tomography of the Temporal Bone on Inverted Imaging by Otologists and Neurotologists

Objective: Radiologists use inverted image high resolution computed tomography (HRCT).Do inverted images help otologists and neurotologists identify temporal bone structures?Methods: Two surveys compared identifying otosclerosis and the neural canals in regular versus inverted images.Survey 1 selected 7 regular/ inverted pairs of HRCT axial images from patients with successful stapedectomies.Seven regular/inverted pairs from non-pathologic HRCT temporal bones were normal counterparts to the otosclerosis bones.Thirty-five respondents reviewed these 28 images.Survey 2 selected 9 regular/ inverted pairs of non-pathological HRCT sections.Fourteen respondents identified the neural canals from the total of 18 images.Criterion-based scoring focused on those respondents with accuracy more than 72%.Results: Twenty percent of respondents could diagnose otosclerosis, and 21% could identify the neural canals, with no significant difference between regular and inverted images. Conclusion:Image orientation did not affect interpretation accuracy in those with the knowledge base to identify temporal bone structures.