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We report on two cases of auditory ossicular anomaly and one case of traumatic ossicular dislocation evaluated with three-dimensional images using MDCT (multidetector-row CT). The first patient was an 18-year-old female, who had noticed hearing impairment in her right ear since she was a child. The second patient was a 32-year-old male, complaining of hearing loss in his right ear after a head injury. The third patient was a 27-year-old female who had hearing impairment in her right ear probably from birth. The first and the second patients underwent surgery, and their congenital ossicular anomaly and traumatic ossicular disarticulation were identified intraoperatively, which were almost corresponding to the findings shown by three-dimensional computed tomography (3D-CT). In both cases, the additional information provided by 3D-CT, together with conventional cross-sectional CT images, improved the ability to evaluate and diagnose the auditory ossicular lesions preoperatively. Although the third patient did not undergo surgery because she preferred observation, 3D-CT clearly showed the abnormality of her ossicles compared with conventional CT images, which helped her and her family to understand the reason for her hearing impairment. Our cases indicate that 3D-CT is useful not only for surgeons to optimize surgical planning but also for patients to understand the condition of their middle ear.

Intraosseous hemangiomas are rare, comprising only 0.5% to 1% of all osseous neoplasms. The most common locations are the vertebral column and the skull bones; nevertheless, the maxillary bone is quite a rare location and only a few cases have been described in the literature thus far. We describe a case of a 48-year-old woman who was referred to our hospital with a suspected maxillary tumor incidentally discovered on (18) F-fluorodeoxyglucose positron emission tomography (FDG-PET) imaging performed during a general medical examination. Computed tomography (CT) demonstrated a 3 cm bony tumor with a honeycomb appearance occupying the left maxillary sinus. Complete surgical resection via the Caldwell-Luc procedure was performed for the purpose of diagnosis and treatment. Histological examination revealed that the tumor was an intraosseous cavernous hemangioma originating from the maxillary bone. Although preoperative angiography and embolization were not performed, intraoperative-blood loss was minimal. No recurrence has been seen in a follow-up period of 3 years.

We retrospectively reviewed 44 cases of major salivary gland lesions surgically resected following preoperative fine-needle aspiration cytology (FNAC). Our objective was to determine the validity of the salivary gland FNAC reporting proposed in 2004 by the Japanese Society of Clinical Cytology. Of the 44 lesions, 33 were in the parotid gland and 11 in the submandibular gland. Of these, 8 lesions were malignant. Two from benign lesions could not be satisfactorily evaluated, and 4 from benign lesions and 1 from a malignant lesion were indeterminate. Results were 3 true positive, 30 true negative, and 4 false negative, with no false positive results. Calculated sensitivity was 42.9% (4/7), specificity 100% (30/ 30), and accuracy 89.2% (34/37). We concluded that using the new reporting decreases ambiguity in clinicians' interpretation of cytology reports, thus benefitting subjects.

Arachnoid cysts are commom intracranial lesions; however, their extension to the paranasal sinus is rare. Here we report a case of arachnoid cyst extending to the sphenoid sinus. Imaging examinations indicated an epidermoid cyst. We then performed endoscopic transsphenoidal surgery for partial resection of the cyst or formation of a drainage route. Opening the cyst wall resulted in a massive CSF leak, indicating an arachnoid cyst. Management of CSF leakage requires complete closure of the defect in the skull base using a fat graft and a pedicle mucosal flap elevated from the nasal septum. An arachnoid cyst should be included in the differential diagnosis of intracranial cystic lesions extending to the paranasal sinuses.