Clinical applications of three-dimensional CT images for diseases of the anterior and middle cranial base

CT scanning has made significant contributions to the diagnostic, therapeutic and prognostic aspects for the managements of the lesions in the paranasal sinuses and the orbit. The current availability of 3-D imaging reformatted from CT scans has added a new dimension to anatomic investigations and pre- and postoperative evaluations of the skull base structures. Twenty-five craniomaxillofacial 3-D CT examinations were performed during the year of the 1989 for the purpose of the diagnosis of the pathology, surgical planning and postoperative evaluation in reconstructive surgery of the skull base. The use of 3-D CT improved the display of the location and volume of the pathology and affords the accurate therapeutic and surgical planning. Preoperative 3-D CT imagings were useful for the display of the bony erosion of the skull base. Stereotaxic 3-D CT imagings were particularly appreciated in the diagnostic aspects of the management of the pathology. In the reconstructive surgery of the skull base, an accurate prefabricated model of the bony defect can be made to aid the surgery. A major limitation of 3-D CT was its inability to reconstruct the pathology of soft tissues with the same fidelity afforded bony structures. (author)