The role of high-resolution computerized tomography as a diagnostic tool in the evaluation and planning of management of patients with chronic otitis media

Mitra, Monali; Thakare, Priti Ashok; Monteiro, Berton; Amle, Dnyanesh

doi:10.4103/mjmsr.mjmsr_30_21

Cited by 2 publications

(1 citation statement)

References 19 publications

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“…This is comparable to the findings of Zaman et al, [22] who discovered cholesteatoma with a sensitivity of (100.0%) and a specificity of 88.1%. Mitra et al, [23] reported a sensitivity and specificity of 100% for the diagnosis of cholesteatoma in their HRCT study of 100 patients. A current study about sigmoid sinus plate integrity showed that CT scanning has correctly identified four out of five patients with eroded sigmoid sinus plates (4/35; 11.4%).…”

Section: Discussionmentioning

confidence: 97%

Comparison of Preoperative Computerized Tomograghic Scan of Temporal Bone Findings with Intra Operative Findings in Patients with Chronic Otitis Media Undergoing Tympanomastoidectomy: A Descriptive Study

Abdulridha,

Attallah,

Bakir

2023

AJMAH

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Background: Since ancient times, chronic suppurative otitis media (CSOM) has been a significant contributor to middle ear illness. Antibiotics have been extremely helpful, but (CSOM) is still a frequent condition, and its consequences present a challenge to both otologists and radiologists. Due to the intricate anatomical nature of the middle ear and inner ear, radiological assessment of the temporal bone is challenging. Aim of the Study: To compare between preoperative CT scan findings of the temporal bone with the operative findings in patients with CSOM undergoing tympanomastoidectomy. Methodology: A Descriptive cross-sectional prospective has been adopted and 35 patients with Chronic Suppurative Otitis Media were admitted at the Department of Otolaryngology/ Alsulaymaniyah Teaching Hospital of Otolaryngology, Head and Neck Surgery, and Zhian Hospital during the period from February to December 2015. A detailed history and careful physical examination, clinical tests revealed that all of the patients had Chronic Suppurative Otitis Media, typically with discharge from the ear and hearing loss. Each patient had their clinical history collected, and they all underwent a thorough ear, nose, and throat examination as well as an attentive otoscopic and microscopic ear examination. Additionally, all patients underwent an audiological evaluation that included pure tone audiometry, tympanometry, and HRCT. Results: Thirty -five patients were included in this study. The mean age of the patients was 33 years; 51.4% were males and 48.6% were females. The most common presenting symptom was aural discharge in 71.4%; the second one was hearing loss in 28.6%. Mastoid pneumatization was found in 82.9% by CT while by surgery, it was found in 17.1%. CT findings showed that middle ear involvement in 11.4%, mastoid involvement in 11.4%, mastoid with middle ear involvement in 54.3%, and EAC, mastoid, and middle ear involvement in 17.1%. While the surgical findings showed middle ear disease in 20%, mastoid involvement in 11.4%, mastoid with middle ear involvement in 57.1%, and EAC, mastoid and middle ear involvement in 11.4%. The CT findings for eroded Malleus, Incus integrity, and stapes in 31.4%, 37.1%, not visualized while surgical findings showed eroded Malleus, Incus, and stapes integrity that 28.6%, 54.3%, and 28.6% respectively. The CT findings for an eroded facial canal, the lateral semicircular canal, the posterior external auditory canal wall, and sigmoid sinus plate integrity were 12.4%, 8.6%, 22.9%, and 11.4% in that order, while the surgical findings of the eroded facial canal, the lateral semicircular canal, and the posterior external auditory canal wall were found in 20.0%, 5.7%, 17.1%, and 14.2% respectively. Both CT and surgical findings of Integrity of the tegmen showed that 32 patients (91.4%) were found to have intact tegmen, and 3 patients (8.6%) had eroded tegmen and both showed that the eroded scutum found in 25.7%. Conclusions: The current study concluded a positive correlation between CT and surgical findings that has many advantages in preoperative planning for the eradication of the disease, choosing the best approach & has a very important role in the orientation of the surgeon during the surgery to avoid any possible complications.

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Section: Discussionmentioning

confidence: 97%

Comparison of Preoperative Computerized Tomograghic Scan of Temporal Bone Findings with Intra Operative Findings in Patients with Chronic Otitis Media Undergoing Tympanomastoidectomy: A Descriptive Study

Abdulridha,

Attallah,

Bakir

2023

AJMAH

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Temporal Bone Cholesteatoma: Typical Findings and Evaluation of Diagnostic Utility on High Resolution Computed Tomography

Zaman¹,

Rangankar²,

Muralinath³

et al. 2022

Cureus

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BackgroundPre-operative assessment of middle ear cholesteatoma is a must for assessing the disease's location, extent, and complication, and high-resolution computed tomography (HRCT) is the modality of choice. Therefore, this study aims to assess the common signs of cholesteatoma on HRCT and its diagnostic ability. MethodsFifty patients with suspected cholesteatoma were considered for the study, which was carried out on an Ingenuity Core 128 slice CT scanner (Philips, Amsterdam, Netherlands). The bilateral temporal bones of 50 patients were assessed for soft tissue density and associated findings. The number of temporal bones with soft tissue density was then correlated with intra-operative and histopathological examinations (HPE). ResultsOut of 100 temporal bones, 63 were diseased, and 37 were normal temporal bones. Epitympanum/Prussak's space was the most involved site with soft tissue density seen in 60/63 (95.2%) diseased temporal bones, followed by aditus ad antrum and mesotympanum, which was seen in 51/63 (80.9%) diseased temporal bones. The majority of the soft tissue lesions were non-dependent, accounting for 43/63 (68.2%) of the diseased temporal bones. Bony erosions were seen in 54/63 (85.7%) and bony expansion in 35/63 (55.5%) of the diseased temporal bones. HRCT showed a sensitivity of 100%, specificity of 88.1%, a positive predictive value (PPV) of 92.1%, a negative predictive value (NPV) of 100%, and accuracy of 95% for detection of cholesteatoma. ConclusionHRCT of the temporal bone precisely demonstrates cholesteatoma's location, extent, and bony changes. Therefore, it has exceptional sensitivity, high specificity, and accuracy in diagnosing cholesteatoma.

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The role of high-resolution computerized tomography as a diagnostic tool in the evaluation and planning of management of patients with chronic otitis media

Cited by 2 publications

References 19 publications

Comparison of Preoperative Computerized Tomograghic Scan of Temporal Bone Findings with Intra Operative Findings in Patients with Chronic Otitis Media Undergoing Tympanomastoidectomy: A Descriptive Study

Comparison of Preoperative Computerized Tomograghic Scan of Temporal Bone Findings with Intra Operative Findings in Patients with Chronic Otitis Media Undergoing Tympanomastoidectomy: A Descriptive Study

Temporal Bone Cholesteatoma: Typical Findings and Evaluation of Diagnostic Utility on High Resolution Computed Tomography

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