High Resolution CT Imaging in Pathologies of Temporal Bone

Abstract

This was a prospective study, done in our institution from January 2016 to August 2017 with a sample size of 90, after due clearance from the institutional ethical committee. Written informed consent was obtained from all patients prior to the study procedure or data collection. Patients of all age group with ear complaints, such as hearing loss, pain, vertigo, ear discharge and tinnitus referred for HRCT temporal bone were included. Patients with a recent history A B S T R A C T Introduction: Diseases of the ear are a common clinical problem, encountered in every day. Clinical examination alone is not sufficient in present days, owing to prevalence, complications and recurrence of various pathologies of the temporal bone, imaging plays a major role in the management and influences the treatment. High-resolution computed tomography (HRCT) offers an excellent resolution, allowing a better understanding of the aetiology, pathology, disease course with early detection of complications. The prospective study aimed to study pathologies of the temporal bone along with their complications on HRCT and to correlate with their surgical findings. Material and Methods: A prospective study done with a sample size of 90 patients with ear complaints, such as hearing loss, pain, vertigo, ear discharge and tinnitus and referred for HRCT temporal bone were included. Ear trauma and head injury, pregnant women and those unwilling to give consent were excluded. HRCT was done using a GE 128 Slice CT scanner and were followed up for surgical or medical methods of management. Images are reconstructed in the ultra-sharp bone algorithm for image reconstruction, analysed for reporting. The intraoperative findings such as middle ear soft tissue density, ossicular erosion, erosion of scutum, tegmen tympani and facial canal, fistulous communication between the middle ear and lateral and posterior semicircular canal. Above findings were analyzed using standard statistical methods. Results: There is an excellent radio-surgical correlation in diagnosing and differentiating cholesteatoma from granulation tissue, identifying malleus erosion, incus erosion, tegmen tympani erosion, scutum erosion, EAC erosion, sigmoid plate dehiscence, high riding jugular bulb, mastoid status/erosion. Moderate to poor radio-surgical correlation was noted in identifying LSCC fistula, stapes erosion and facial canal erosion. Conclusion: HRCT is a valuable imaging modality through which pre-operative assessment of temporal bone pathologies can be done efficiently with reasonable accuracy, cost and precision for making surgical decisions. Hence it helps the surgeon to decide the course of action in particular clinical problem.