Hazem Medhat Matta DO, Abstract Co-Author: Nothing to Disclose

Vijay Kumar Mittal MD, Abstract Co-Author: Nothing to Disclose

Sangam Gurudas Shet Kanekar MD, Presenter: Nothing to Disclose

1) To learn the radiological anatomy of petrous apex and its relationship with surrounding brain structures and cranial nerves. 2) To highlight the important and salient differentiating points between the various petrous apex pathologies

Petrous apex (PA)  lies anteromedial to the inner ear between the sphenoid bone anteriorly and occipital bone posteriorly. It has close anatomic relationship with the brainstem and cranial nerves. Pathology in the PA could manifest into various neurological and cranial nerve deficits. We retrospectively reviewed the imaging studies from our PACS system of 53 patient with PA lesion. Clinical features included cranial neuropathies, vertigo, dizziness and fullness in the ear. All patients had high resolution CT scan of the temporal bone and contrast enhanced high resolution MRI for IAC. Lesions are classified into a) anatomic variation: asymmetric fatty marrow, trapped fluid; b) infection; c) cholesteatoma and cholesterol granuloma; d) neoplastic lesions: primary involving the bone and secondary/metastasis to apex; e) vascular  f) osseous.

Imaging plays a vital role in diagnosing the normal anatomical variation, classifying the various pathologies and avoiding potentially unnecessary complex surgery in this location. This exhibit will be core learning module for anatomy and pathologies of petrous apex.  

Matta, H, Mittal, V, Kanekar, S, Imaging of Petrous Apex.  Radiological Society of North America 2013 Scientific Assembly and Annual Meeting, December 1 - December 6, 2013 ,Chicago IL. http://archive.rsna.org/2013/13016860.html