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On-demand course library with video lectures, expert case reviews, and more
Fellowship Certificate™ Programs
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Complete all of your state CME requirements in one convenient place.
Noon Conference (Free)
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Dr. Resnick's MSK Conference
Learn directly from the MSK Master himself.
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Supplement your training program with case-based learning for residents, registrars, fellows, and more.
For Private Practices
Upskill in high growth, advanced imaging areas.
Compliance
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Emergency Call Prep
Prepare trainees to be on call for the emergency department with this specialized training series.
42 topics, 3 hr. 3 min.
Introduction to Imaging The Middle Ear
5 m.Anatomy of the Middle Ear on CT
10 m.Otomastoiditis Summary
9 m.Otomastoiditis Case Study
3 m.Otomastoiditis w/ Labyrinthitis
7 m.Otitis Media with Ossicular Erosion
5 m.Mastoiditis with Abscess
5 m.Coalescent Mastoiditis Extensive Complications
6 m.Cholesteatoma Summary
8 m.Cholesteatoma Case Study
6 m.Cholesteatoma, Facial Nerve Dehiscence
6 m.Granulation Tissue Vs. Cholesteatoma
6 m.Post Operative MR Cholesteatoma
2 m.Total Ossicular Replacement Prosthesis (TORP)
2 m.Paraganglioma Summary
6 m.Glomus Tympanicum DDX VVM
3 m.Glomus Tympanicum
3 m.Glomus Jugulotympanicum
6 m.Right Glomus Tympanicum, Left Glomus Jugulare, Meningioma, Aneurysm, Multiple Paragangliomas
5 m.Red Retrotympanic Masses DDX
6 m.Persistent Stapedial Artery
4 m.Right Facial Nerve Hemangioma
3 m.Left sided Facial Hemangioma
2 m.Cholesterol Granuloma
6 m.Middle Ear Congenital Anomalies – Summary
6 m.Second Branchial Apparatus Anomaly
1 m.Encephalocele Congenital vs. Acquired Review
4 m.Middle Ear Benign Neoplasms and Normal/Abnormal Facial Enhance
6 m.Facial Schwannoma
5 m.ELST’s – Summary
4 m.Endolymphatic Sac Tumor (ELST)
4 m.VonHipple Lindau with ELST
3 m.Meningioma (Middle Ear)
4 m.Malignant Processes of the Middle Ear – Summary
4 m.Leukemic Chloroma Mastoid
4 m.Nasopharyngeal Carcinoma with MEC Extension
2 m.Fractures in the Middle Ear – Summary
6 m.Fractures with Incudo-Stapedial Dislocation
4 m.Post-op Cholesteatoma, Cholesteatoma Complications
6 m.Middle Ear Epidermoid, Temporal Bone Fx, High Riding Jugular Bulb, Dehiscence
7 m.Canal Wall Up Mastoidectomy, Recurrent Cholesteatoma, TORP
4 m.Middle Ossicular Fusion, EAC Atresia
4 m.0:01
This is a patient who had a retrotympanic
0:04
vascular mass and had some pulsatile tinnitus.
0:08
The study is actually very nice from the
0:10
standpoint of the ossicular anatomy showing
0:12
that nice ice cream and ice cream cone that
0:16
we have described in the past and the nice
0:19
articulation between the head of the malleus
0:21
and the short process of the incus.
0:22
But you also get a really nice view of the
0:25
circular of the stapes here.
0:28
I mean, I can even magnify a little
0:29
bit more if I wanted.
0:31
So we're seeing the stapes inserting
0:34
at the oval window very nicely here.
0:36
And the incudostapedial joint right here,
0:39
you actually can even see from the pyramidal
0:42
eminence the little soft tissue which is the
0:44
stapedius muscle going to the
0:46
capitulum of the stapes.
0:50
And we also see the muscle going to the neck of
0:52
the malleus from the cochleariform process.
0:55
And that's the tensor tympani.
0:57
However, getting to the pathology,
1:00
as you can see here,
1:01
this is the cochlear promontory
1:04
and the round window niche.
1:06
And there is a soft tissue mass which is present
1:09
overlying the cochlear promontory.
1:12
Has a little bit of a kind of a moth-eaten
1:16
appearance to the bone adjacent to it.
1:19
And here you can see it again,
1:21
it's going a little bit more inferior than usual
1:24
for what we would expect to be a vascular
1:28
region in the retrotympanic space.
1:30
But this was indeed a glomus tympanicum in this
1:33
case, with the moth-eaten appearance of the bone,
1:38
I would consider a venous vascular malformation
1:41
in the differential diagnosis.
1:43
You notice that this lesion does not go
1:46
down as far as the jugular foramen.
1:48
So here's our big jugular foramen, jugular
1:50
spine and there's no erosiveness to it.
1:54
And it is not contiguous with this soft tissue
1:57
mass overlying the cochlea and the soft
2:01
tissue just below the cochlea.
2:04
So this would not be a glomus jugulotympanicum.
2:08
This is a glomus tympanicum.
2:10
Differential diagnosis.
2:12
Venous vascular malformation or hemangioma
2:15
in the differential diagnosis.
Interactive Transcript
0:01
This is a patient who had a retrotympanic
0:04
vascular mass and had some pulsatile tinnitus.
0:08
The study is actually very nice from the
0:10
standpoint of the ossicular anatomy showing
0:12
that nice ice cream and ice cream cone that
0:16
we have described in the past and the nice
0:19
articulation between the head of the malleus
0:21
and the short process of the incus.
0:22
But you also get a really nice view of the
0:25
circular of the stapes here.
0:28
I mean, I can even magnify a little
0:29
bit more if I wanted.
0:31
So we're seeing the stapes inserting
0:34
at the oval window very nicely here.
0:36
And the incudostapedial joint right here,
0:39
you actually can even see from the pyramidal
0:42
eminence the little soft tissue which is the
0:44
stapedius muscle going to the
0:46
capitulum of the stapes.
0:50
And we also see the muscle going to the neck of
0:52
the malleus from the cochleariform process.
0:55
And that's the tensor tympani.
0:57
However, getting to the pathology,
1:00
as you can see here,
1:01
this is the cochlear promontory
1:04
and the round window niche.
1:06
And there is a soft tissue mass which is present
1:09
overlying the cochlear promontory.
1:12
Has a little bit of a kind of a moth-eaten
1:16
appearance to the bone adjacent to it.
1:19
And here you can see it again,
1:21
it's going a little bit more inferior than usual
1:24
for what we would expect to be a vascular
1:28
region in the retrotympanic space.
1:30
But this was indeed a glomus tympanicum in this
1:33
case, with the moth-eaten appearance of the bone,
1:38
I would consider a venous vascular malformation
1:41
in the differential diagnosis.
1:43
You notice that this lesion does not go
1:46
down as far as the jugular foramen.
1:48
So here's our big jugular foramen, jugular
1:50
spine and there's no erosiveness to it.
1:54
And it is not contiguous with this soft tissue
1:57
mass overlying the cochlea and the soft
2:01
tissue just below the cochlea.
2:04
So this would not be a glomus jugulotympanicum.
2:08
This is a glomus tympanicum.
2:10
Differential diagnosis.
2:12
Venous vascular malformation or hemangioma
2:15
in the differential diagnosis.
Report
Description
Faculty
David M Yousem, MD, MBA
Professor of Radiology, Vice Chairman and Associate Dean
Johns Hopkins University
Tags
Temporal bone
Neuroradiology
Neoplastic
Head and Neck
CT
Brain
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