Temporal bone CT for the ear surgery. Present and future

Temporal bone high-resolution CT (HRCT) is a commonly performed imaging examination before the ear surgery. HRCT offers good-quality images, however, there has been a little improvement in the HRCT imaging techniques over the last 30 years. In this paper, we introduce different types of CT other than HRCT that are applicable to the temporal bone imaging. Cone-beam CT (CBCT) is another popular CT technique that provides images with a high spatial resolution, with low radiation dose exposure; the tradeoff is the high rate of artifacts and low signal-to-noise ratio. Ultra-high resolution CT (U-HRCT) is a successor technique to HRCT. Now clinically available, U-HRCT provides precise images with high signal-to-noise ratios. Intra-operative images can be obtained using mobile CBCT equipment (m-CBCT) and a multi-axis C-arm with robotic technology. m-CBCT is a truly mobile CT equipment that provides satisfactory image quality. The multi-axis robotic C-arm equipment is mandatory for conducting transcatheter aortic valve implantation, and many hospitals are equipped with this device. CT-like images using this device can be an effective option for challenging cases. Photon counting CT (PCCT) is a next-generation CT that offers images with high spatial resolution and high contrast resolution at low radiation doses. Clinical application of PCCT in the field of ear surgery is expected in the near future. (author)