Visualization of anterior skull base defects with intraoperative cone-beam CT

Bachar, Gideon, Barker, Emma, Chan, Harley, Daly, Michael J., Nithiananthan, Sajendra, Vescan, Al, Irish, Jonathan C. and Siewerdsen, Jeffrey H. (2010) Visualization of anterior skull base defects with intraoperative cone-beam CT Head and Neck, 32, (4), pp. 504-512. (doi:10.1002/hed.21219). (PMID:19693942).


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Background: the role of cone-beam CT (CBCT) in demonstrating anterior skull base defects (ASBDs), differing in size and location, was investigated. The study was designed to describe the potential advantage of CBCT in the setting of an intraoperative cerebrospinal fluid (CSF) leak.

Methods: in all, 120 ASBD were evaluated in 5 cadaver heads. Orthogonal and oblique slices were reconstructed. Observer studies assessed the visibility of ASBD in each location as a function of defect size.

Results: for 1-, 2-, and 4-mm defects, the percentage that were undetectable ranged from 20% to 33%, 0% to 14%, and 0% to 5%, respectively. Confident breach detection increased with defect size and was most challenging in the lateral lamella and cribriform. CBCT permitted confident detection of ASBD as small as about 2 mm in the fovea ethmoidalis and planum. Oblique views were found to be superior to orthogonal planes.

Conclusions: the ability to identify ASBD depended on the size and location of defect. Oblique viewing planes were optimal for ASBD visualization

Item Type: Article
Digital Object Identifier (DOI): doi:10.1002/hed.21219
ISSNs: 1043-3074 (print)
ePrint ID: 180057
Date :
Date Event
April 2010Published
Date Deposited: 06 Apr 2011 13:22
Last Modified: 18 Apr 2017 02:32
Further Information:Google Scholar

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