On the Importance of Proper Window and Level Settings in Temporal Bone CT Imaging

Abstract

During a discussion on temporal bone imaging, a group of resident trainees in otolaryngology were asked to corroborate the finding of a fracture in set of images that were supposed to be representative of a fracture involving the otic capsule.1 (Figure 1)
 Their comments included the following statements:“The image still does not clearly identify the fracture. It would have been better if the images were set to the optimal bone window configuration...”
 “The windowing must be of concern as well. The exposure setting for the non-magnified view is different from the magnified ones. One must observe consistent windowing in order to assess the fractures more accurately.”
 “...the images which demonstrate a closer look on the otic capsule areas are not rendered in the temporal bone window which makes it difficult to assess.”“...aside from lack of standard windowing...”