Cautionary High-resolution Computed Tomography Findings for the Presence of Facial Canal Dehiscence in Patients with Cholesteatoma

Baklacı, Deniz; Kuzucu, İhsan; Güler, İsmail; Kum, Rauf Oğuzhan; Özcan, Müge

doi:10.7759/cureus.6717

Cited by 3 publications

(1 citation statement)

References 23 publications

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“…[ 15 ] Even one of the studies has revealed a specific sign (mass effect sign) for diagnosing cholesteatoma on HRCT. [ 16 ] Thus, similar to our study many papers have documented that HRCT scan findings correlate well with surgical findings for cholesteatoma and bony erosions,[ 14 15 16 17 18 19 20 21 22 23 ] however, few studies have disputed the above findings. [ 24 25 ] This may be due to the difference in the technical parameters used for the HRCT acquisition in different studies as well as the varying expertise of the radiologists involved in these studies.…”

Section: Discussionsupporting

confidence: 88%

High-resolution computed tomography (HRCT) in pediatric and adult patients with unsafe chronic suppurative otitis media (CSOM) and its surgical correlation

Singh

Rai

Singh

et al. 2020

J Family Med Prim Care

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Background and Aim: Atticoantral, alias unsafe type of CSOM affects the posterosuperior part of the middle ear cleft and is frequently coupled with complications and bony erosions. This study aimed to correlate the high-resolution computed tomography (HRCT) temporal bone and intraoperative findings in the patients with the unsafe type of CSOM. Methods: This prospective study included 50 patients (28 males: 22 females; mean age 24 ± 14 years) who presented with clinically suspected unsafe CSOM. All patients underwent HRCT of the temporal bone and subsequent surgical procedure. The intraoperative and histopathological findings were compared with HRCT findings. Descriptive statistics, sensitivity, specificity, and positive and negative predictive value for HRCT were calculated. Student's t -test and Chi-square test were performed. Results: Out of 50 patients, left, right, and bilateral ear involvement were seen in 42% (21/50), 38% (19/50), and 20% (10/50) patients, respectively. Ear discharge was the most common symptom (100%) followed by earache (66%), vertigo (16%), and tinnitus (14%), respectively. Cholesteatoma was reported in 82% (49/60) of ears on HRCT while histopathological and intraoperative evaluation confirmed the diagnosis in 40 out of 49 ears. In 18% (11/60) ears, the cholesteatoma was not diagnosed on HRCT evaluation; however, the intraoperative and histopathological assessment revealed cholesteatoma in six patients while the rest had granulation tissue. For detection of ossicular erosions, tegmen erosions, erosions of facial nerve canal, erosions of sigmoid sinus plate, and erosions of lateral/posterior semicircular canals; HRCT had high sensitivity (86.44%–100%) and specificity (93.33%–100%). Conclusion: HRCT has a superb correlation with intraoperative findings and is a valuable tool for preoperative assessment of temporal bone pathologies.

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