The Correlation of Temporal Bone CT With Surgery Findings in Evaluation of Chronic Inflammatory Diseases of The Middle Ear

“…Incus was the most commonest ossicle to be involved. Incus was seen to be eroded in almost all cases of cholesteatoma [9], followed by stapes and malleus, in accordance with the findings of Keskin et al [18]. In CT Scan Malleus and body of incus are visualized easily.…”

Section: Ossicular Erosionsupporting

confidence: 72%

Role of CT Mastoids in the Diagnosis and Surgical Management of Chronic Inflammatory Ear Diseases

Majeed¹,

Reddy²

2016

Indian J Otolaryngol Head Neck Surg

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Chronic Suppurative Otitis Media (CSOM) is a chronic inflammation of middle ear cleft. It presents with discharging ear and decreased hearing. The diagnosis is mostly on clinical examination with otoscope or oto endoscope. Computerised Tomography (CT) of mastoids is done to evaluate the extent of the disease and its complication. High resolution CT is now the investigation of choice for temporal bone disease. This study emphasizes on the importance of CT scan in diagnosis of inflammatory ear diseases and most importantly identifying pitfalls or complications which a surgeon can come across during surgery. The aims and objectives of this study is (1) to establish the efficacy of CT in the diagnosis of the complications and surgical management of chronic inflammatory pathologies of middle ear. (2) To find subgroups of CSOM where CT is particularly useful. In this series, a total of 25 cases presenting to our OPD at Govt. ENT Hospital between 2013 and 2014 have been diagnosed and findings of surgery correlated with HRCT scan of temporal bones done preoperatively. In this study, 64 % of the patients were male and incidence of CSOM with patients undergoing surgery belonged to the age group 21-30 years (32 %). The most common presenting symptom was ear discharge (92 %) and decreased hearing (96 %). The most common type of pathology in this study was attic perforation (36 %) and granulations (40 %) followed by cholesteatoma (36 %) and mucosal edema (16 %). Not all cases presented with complications, facial palsy (12 %) and mastoid abscess (8 %) were among few complications seen. 14 patients (56 %) of 25 cases underwent simple cortical mastoidectomy followed by 9 cases (36 %) for modified radical mastoidectomy and atticotomy for 2 cases (8 %). CT scan findings correlated well with surgical findings for cholesteatoma, middle ear mass and bone erosions. Where as for ossicular integrity and facial canal dehiscence, there was a discrepancy.

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“…[16][17][18][19] Computed tomography detection of facial canal dehiscence has a sensitivity of 66-66.6 per cent and a specificity of 84-98 per cent. 20,21 Hence, it could be hypothesised that our second and third cases did actually have microdehiscences of the fallopian canal on the side of the development of their palsy, which were not obvious on their CT scans. This hypothesis is based on the present understanding that barotrauma in association with bony fallopian canal dehiscence is the most likely explanation for the observed facial palsy, despite the fact that two of our three patients had intact bony canals evident on their CT scan.…”

Section: Discussionmentioning

confidence: 99%

Facial paralysis during air travel: case series and literature review

et al. 2012

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Objective: We report three cases of recurrent, unilateral facial palsy associated with air travel.Method: The three cases are presented, along with a brief literature review concerning barotrauma and its association with air travel and facial palsy.Results: All three patients experienced unilateral facial paralysis during air travel, accompanied by additional symptoms which varied between cases. Symptoms resolved spontaneously in all cases. Two patients received ventilation tube insertion to prevent further recurrence. Computed tomography scanning revealed no bony defect in two patients, while the third exhibited dehiscence of the facial canal which may have contributed to the condition.Conclusion: Available evidence suggests that eustachian tube dysfunction can contribute to increased pressure within the middle ear, leading to neuropraxia of the facial nerve. Cases of facial paralysis associated with air travel are underreported. Since there is no evidence-based management protocol for this condition, further investigation of its pathology is encouraged in order to improve our understanding.

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The Correlation of Temporal Bone CT With Surgery Findings in Evaluation of Chronic Inflammatory Diseases of The Middle Ear

Abstract: Aim: Computerized tomography (CT) examination of temporal bone is a routine procedure in the diseases of the middle ear. The aim of this

Cited by 22 publications

References 29 publications

Radiological study of the temporal bone in chronic otitis media: Prospective study of 50 cases

Radiological study of the temporal bone in chronic otitis media: Prospective study of 50 cases

Role of CT Mastoids in the Diagnosis and Surgical Management of Chronic Inflammatory Ear Diseases

Facial paralysis during air travel: case series and literature review

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