Abstract

The middle ear (ME) is a notoriously complicated anatomic structure, geometrically arranged as irregular interlinked spheroidal and polyhedric cavities dug inside the temporal bone (TB). The bony walls of these cavities are radiopaque and form the bony support for the D-Organ that we have previously defined as corresponding to the epithelium covering the Antrum walls (belonging to the central cavities of the middle ear) and the walls of mastoid and petrous cavities (the peripheral cavities of the ME). The aim of the study is to define an exact method for categorizing a Unilateral Radiographic COnformation of the TEmporal Bone in Schuller’s projection (URCOTEBS) under one of the four defined conformations and using it for practical everyday clinical purposes. The conclusion is that a radiograph in Schuller’s projection is a concrete way of storing precise information on the status (health/disease) of the D-Organ and therefore of the ME mucosa. These data is encoded within the image and we aim to decode and translate them into clinical data. The URCOTEBS results in an overlapping projection of all bony cavities that comprise the General Endo-temporal Bony Cavity Complex onto the same plain (film). This characteristic of classical film imaging constitutes an advantage from the multiple CT sections, as far as our proposed approach goes, because the set of stochastic information is found in the whole of the cavities taken as one on the same image, to which the measurement gauges can be easily applied. The decoding must be performed accordingly, and this occurs much faster with conventional radiography. This image of the TB in Schuller’s projection is a mirror that reflects the status of the ME mucosa, and URCOTEBS encodes the physiological state of the D-Organ. The present work gives, through stochastic methods, the key to decoding this information into clinical language. In ascending order of their projection areas (projection of their Variable Geometry Peripheral Endo-temporal Bony Cavity Complex) we can recognize URCOTEBS_d, URCOTEBS_c, URCOTEBS_b, and URCOTEBS_a. The corresponding Greek letter designates the state of disease for each of these conformations: URCOTEBS_δ, URCOTEBS_γ, URCOTEBS_β, URCOTEBS_α, and the capital letters define their state of health: URCOTEBS_D, URCOTEBS_C, URCOTEBS_B, URCOTEBS_A. URCOTEBS_d is the smallest unilateral radiographic conformation of the TB in Schuller’s projection and is, by definition, a radiographic image of the state of disease of the D-Organ. The probability of disease in URCOTEBS_d is 100%. This radiographic system is readily available and clinically usable.

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