Current Multiplanar Imaging of the Stapes
Philippe Henrot,
Sandrine Iochuma,b,
Toufik Batcha,
Laurent Coffinetc,
Alain Bluma and
Jacques Rolanda
a Department of Radiology, Centre Alexis Vautrin, Avenue de Bourgogne, Vandoeuvre-les-Nancy, France
b Department of Radiology Guilloz CHU Nancy, University of Nancy, Nancy, France
c Department of Head and Neck Surgery, CHU Nancy, University of Nancy, Nancy, France
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FIG 1. Coronal reformation demonstrating the stapes superstructure. A, The anterior crus (small arrow), the stapes head (small arrowhead), and the lenticular process of the incus (large arrowhead) are distinctly depicted, forming a "V" with the long process of the incus. The oblique axial images are reformatted in this plane. B, The angle between the OAP and the AP is 31° in this example.
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FIG 2. Oblique axial reformation in the plane of the stapes superstructure. All components of the stapes—the head, the crura, and the footplate—are depicted on a single view.
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FIG 3. Angle between the plane of the footplate and the S-line intersecting the midportion of the footplate and crossing the stapes head. In this example the angle is 88.3°. The S-line also crosses the long process of the incus.
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FIG 4. A, Posttraumatic conductive hearing loss in a 20-year-old man. Axial view only shows a partial view of the stapes superstructure.
B, Coronal reformation in the plane of the oval window. The stapes superstructure is visible in the ovale window niche.
C, Oblique axial view in the plane of the stapes superstructure. The anterior and posterior stapes crura are interrupted, and the stapes appears posteriorly displaced.
D, Drawing the S-line perpendicular to the footplate and intersecting its midportion highlights the posterior displacement of the stapes arch. Surgical exploration confirmed the fracture of the anterior and posterior stapes crura. The continuity of the ossicular chain was restored with a PORP prosthesis.
E, Oblique axial view of the contralateral ear. The S-line crosses the stapes head and the long process of the incus.
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FIG 5. A, Posttraumatic conductive hearing loss in a 57-year-old man. Axial image shows a partial view of the stapes head of the long process of the incus.
B, Coronal reformation shows the presence of the stapes superstructure in the ovale window niche.
C, Oblique axial view in the plane of the stapes superstructure. The anterior crus is interrupted and the stapes head is posteriorly displaced in relationship to the long process of the incus.
D, Drawing the S-line perpendicular to the footplate and intersecting its midportion highlights the posterior displacement of the stapes. Surgical exploration confirmed the presence of a fracture of the anterior crus associated with an intact posterior crus, an incustapedial dislocation with a fibrous residual band in between, and a horizontal fissuration of the footplate. Continuity of the ossicular chain was restored by interposing a cartilagineous patch between the long process of the incus and the stapes head.
E, Oblique axial view of the contralateral normal ear. The S-line crosses the stapes head and the long process of the incus.
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