Modern otology increasingly relies on high-resolution CBCT to visualize the temporal bone, ossicular chain, semicircular canals, cochlear structures, and external auditory canal with exceptional spatial detail at a fraction of the radiation dose of medical CT. A growing body of literature supports CBCT as a safe, accurate, and clinically efficient tool for evaluating chronic ear disease, surgical planning, and postoperative assessment.
Ultra–high spatial resolution for temporal bone detail
CBCT provides voxel sizes as small as 0.1 mm, enabling visualization of microanatomy that is difficult to appreciate on conventional CT. Studies demonstrate CBCT’s superior delineation of ossicles, stapes footplate, scutum, tegmen, facial nerve canal, and prosthetic implants compared with MDCT (Dalchow et al., 2006; Redfors et al., 2012). This level of detail supports accurate diagnosis of otosclerosis, cholesteatoma-related bony erosion, and congenital malformations.
Significantly lower radiation dose
Multiple studies confirm that temporal bone CBCT delivers up to 10–20× lower radiation doses than multislice CT, without compromising diagnostic accuracy (Nieminen et al., 2019; Khalil et al., 2022). This is especially beneficial for:
- Younger patients
- Recurrent or chronic conditions requiring serial imaging
- Pre- and post-operative planning for implantable hearing devices
Lower dose with high anatomic accuracy supports CBCT as a preferred modality for many routine otologic questions.
High diagnostic accuracy for common otologic conditions
CBCT has been shown to match or exceed the diagnostic confidence of conventional CT for:
- Otosclerosis (Pauwels et al., 2015)
- Chronic otitis media / mastoiditis (Bächinger et al., 2016)
- Temporal bone trauma (Curtin et al., 2019)
- Cochlear and ossicular prosthesis positioning (Kemp et al., 2020; Redfors et al., 2012)
In several studies, CBCT improved visualization of prosthesis placement and reduced indeterminate postoperative exams (Kemp et al., 2020).
Superior visualization of implantable hearing devices
CBCT is increasingly used for cochlear implant evaluation because of its ability to show:
- Electrode array location and insertion depth
- Scalar translocation
- Cochleostomy vs. round window approach
- Tip fold-over
Compared to CT, CBCT offers less metal artifact, improving post-operative decision-making (Verbist et al., 2010; Zanoletti et al., 2020).
Ideal for office-based otology workflows
Because CBCT scanners are quiet, fast, and require less immobilization, patients tolerate them extremely well. Scans are typically completed in under 20 seconds with minimal motion artifact. Studies highlight improved patient experience and workflow efficiency in ENT clinics that adopt in-office CBCT (Nieminen et al., 2019).
Validated for surgical planning & navigation
CBCT’s high geometric accuracy (often <0.2 mm deviation) makes it useful for:
- Preoperative mapping of facial nerve canal, sigmoid plate, ossicular chain
- Balloon dilation planning for eustachian tube dysfunction
- Navigation-guided mastoid and middle ear surgery (Zanoletti et al., 2020)
- Accuracy and artifact reduction contribute to reliable surgical guidance.