Temporal and ear imaging: normal or abnormal findings?

The temporal bone is known as an area of complex anatomy. In routine diagnostic imaging the tiniest structures may be occult or poorly visualized, especially by radiologists and clinical doctors not particularly skilled in temporal bone imaging. Doubtful findings, small bony structures, thin canals and fine sutures cause sometimes problems in the differentiation between normal and abnormal situations; anatomical variants should not be confused with pathological structures. So, recognize the existence of infrequent or not so evident findings requires robust knowledge of this regional anatomy, regarding not only the bone structures, but also the nervous and vascular ones. Moreover, familiarity with embryological and developmental notions may help to diagnose physiological aspects or anatomical variants. The aim of this paper is not an exhaustive description of each temporal bone structure and all possible anatomical variants in this region, but to remind some particular ear and temporal radiological findings which can imply problems of differential diagnosis or, on the other hand, which should be described for justify the symptoms, report any dangers of complications in case of pathology or alert the surgeon if surgical therapy is needed.