The temporal bone is a small but anatomically complex region for which the acquisition of a basic knowledge of anatomy represents a significant achievement. Review of temporal bone imaging studies requires a highly structured and systematic approach, in order to prevent missing important but often subtle imaging findings. Additionally, good imaging technique is critical, and time spent optimizing protocols will yield substantial dividends. Currently, one should interpret studies with submillimiter acquisition and reconstruction thicknesses, with the right and left sides reconstructed separately at small field of views. A minimum of axial and coronal planes should be reviewed; many additionally interpret sagittal images, with oblique planes available to aid in specific diagnostic issues, such as superior semicircular canal dehiscence. Inflammatory disease of the temporal bone can be broadly divided into acute and chronic processes; these differ not only in duration of disease, but most importantly, in etiology. Acute otitis media represents an infection that typically ascends from the upper respiratory tract and is most common in children. Chronic otomastoiditis is a result of Eustachian tube dysfunction and is typically not associated with infection. Both are imaged primarily to look for complications, as the primary diagnosis is made clinically. A wide variety of tumors affect the temporal bone, including those found elsewhere intracranially and at the skull base, including meningioma, schwannoma and paraganglioma. The skin of the external auditory canal is susceptible to those lesions that may affect skin anywhere, including squamous and basal cell carcinomas, as well as melanoma. Other tumors, such as metastases, myeloma and lymphoma, are primary to the osseous components of the temporal bone and are most commonly found at the petrous apex.

Temporal Bone Imaging.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14000613.html