High Resolution Computed Tomography Findings of Temporal Bone in Patients With Unsafe Chronic Suppurative Otitis Media.

Abstract

CSOM is defined as chronic inflammation of mucoperiosteal lining of middle ear cleft, i.e. eustachian tube, middle ear and mastoid. Unsafe CSOM is associated with marginal/ attic perforations and cholesteatoma, which may produce multiple complications. It is a potentially serious condition as it can progressively enlarge and cause erosion into neighbouring structures, giving rise to serious complications. HRCT provides information regarding the extent of disease and depicts anatomical variations, which may lead to complications during surgery. The aim of this study was to assess the usefulness of HRCT imaging of temporal bone in cases of unsafe CSOM. In an IRB approved cross-sectional observational study of consecutive 50 patients with clinically diagnosed unsafe CSOM, HRCT of temporal bone was performed. Patients not fit for CT scan e.g., pregnant patients were excluded. HRCT was performed on Philips Brilliance 40 slice CT. Collimation was set at 190mm with scan time of 4.79 seconds with kVp of 140 and mAs of 350. HRCT findings of these patients were compared with the intraoperative findings of those patients who underwent surgery. Standardised statistical methods were used. It was found to be male predominant disease with a mean age of 25.5 years. The most common finding on HRCT was soft tissue density involving the middle ear cleft. Cholesteatoma caused ossicular erosion with the incus being most commonly affected. This study concludes that HRCT should be done in all patients of unsafe CSOM to know the extent of disease which guide in surgical approach and treatment plan.