An Exploratory Study of High Resolution Computed Tomography of Temporal Bone in Chronic Otitis Media (original) (raw)
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High resolution computed tomography of temporal bone in the evaluation of otologic diseases
International Journal of Otorhinolaryngology and Head and Neck Surgery, 2017
HRCT is particularly helpful in evaluating the anatomy and pathology of external auditory canal, middle ear cavity, vestibular aqueduct, tegmen tympani, sigmoid sinus plate, vertical segment of facial nerve canal, sinodural angle, carotid canal, jugular fossa, infra and supralabrynthine air cells and temporomandibular joint; both soft tissue extension and significantly sensitive ABSTRACT Background: Conventional radiological methods like X-ray mastoid have limited ability to delineate the details of the complex temporal bone and cochlea-vestibular anatomy and disease pathology. This can be overcome by the use of High resolution computed tomography (HRCT) evaluation of the temporal bone. HRCT is helpful in evaluating the anatomy and pathology type and extent of disease, thereby helps in preoperative planning. Methods: The CT scan of forty five patients attending the outpatient department of otorhinolaryngology in a tertiary care centre between August 2014 to August 2017 was evaluated in this study. Each CT scan was interpreted by an otolaryngologist and a radiologist and interpretation was by consensus. The data collected was evaluated and results are reported as rates and proportions (%). Results: The study evaluated CT scan of 45 patients of which 35 were male patients and 10 were female patients with age ranging from 5 years to 75 years. Most of these patients belonged to the 21-30, 31-40 age groups [9 (20%) in each group]. Infections of middle ear cleft (all with cholesteatoma), fractures of the temporal bone, anomalies and tumors of the external auditory canal and middle ear were the pathologies observed in these CT scans with infection (otomastoiditis) [23 (51.1%)] being the most common pathology observed. Conclusions: Pre-operative CT scan may not only help in identifying the nature, extent of infectious disease including ossicular, bony erosions; it may also identify anomalies in the temporal bone and surrounding structures. Thus, HRCT temporal bone will help the surgeon in planning effective surgical strategy, reducing morbidity during the surgery.
Erciyes Tıp Dergisi/Erciyes Medical Journal, 2015
Objective: The aim of the present study was to investigate the diagnostic confidence level of preoperative 160-slice computed tomography (CT) findings compared with that of perioperative findings about anatomic variations in the structure of the facial canal, lateral semicircular canal, and dural plate. Materials and Methods: Fifty-five patients who presented with middle ear pathology to Department of Otolaryngology, Afyon Kocatepe University Faculty of Medicine were included in the study, and the mean age was 42 (±15.55) years. Preoperative CT images of the temporal bone were obtained by an 80-detector row CT scanner. Results: The sensitivity, specificity, and positive and negative predictive values of preoperative high-resolution CT (HRCT) were 52%, 88%, 73%, and 75%, respectively, for determining the presence of facial canal dehiscence; 50%, 89%, 71%, and 76%, respectively, for determining the presence of tympanic segment dehiscence; 71%, 96%, 71%, and 96%, respectively, for determining the presence of lateral semicircular canal dehiscence; and 100%, 96%, 50%, and 100%, respectively, for detecting the presence of dural plate defects. Conclusion: The compatibility of HRCT findings with surgical findings in determining the presence of dehiscence of the facial canal and its tympanic segment was moderate, while it was good in determining the presence of dehiscence of the lateral semicircular canal and the defect of the dural plate.
International Journal of Otorhinolaryngology and Head and Neck Surgery
Background: High Resolution Computed Tomography (HRCT) has widely replaced conventional techniques (X-Ray Mastoid bone) for temporal bone imaging. The most significant use of computed tomography lies in evaluation of cases of Chronic Suppurative Otitis Media (CSOM). The objective of the study was to evaluate the usefulness of HRCT scanning of temporal bone in defining the extent and severity of disease in patients with CSOM, thereby altering the surgical plan and outcome. Methods: This prospective study was conducted at a tertiary care hospital in Ahmedabad. After obtaining approval from IEC (Institutional Ethical Committee), study was carried out on 50 patients diagnosed with CSOM of atticoantral type. Written informed consent of all patients was taken before enrollment in the study. HRCT scan findings were reviewed and correlated with per-operative findings. Results: Out of total 50 patients of CSOM, 26 (52%) were males. Majority of the patients (70%) were in the age group of 11 to 30 years. Left ear was involved in 40% of the patients. Majority of the patients (80%) presented with chief complaint of otorrhoea. In the present study, External Auditory Canal (EAC) was seen normal in majority of patients (82%) both radio logically and per operatively. HRCT scan was found to be very sensitive (96%) in diagnosing cholesteatoma. The sensitivity of HRCT for diagnosing disease in epitympanum, antrum and aditus was found to be 100%, 97% and 88% respectively. CT scans diagnosed erosion of malleus with 100% sensitivity and specificity and erosion of incus with 91% sensitivity and 100% specificity. Conclusions: HRCT was helpful in determining the anatomy of the middle ear and mastoid, and accurately predicted the extent of the disease process of CSOM.
2016
BACKGROUND AND OBJECTIVES: To study the HRCT temporal bone findings in chronic middle ear infections with reference to its extent and complications. MATERIALS AND METHODS: After an initial clinical assessment, 30 patients diagnosed clinically with chronic suppurative otitis media (CSOM) were referred for a HRCT of temporal bone which was done with a Siemens’ 16 slice MDCT scanner. RESULTS: Of the 30 patients, 60% were males and 40% were females. Otorrhoea (100%) is the most common symptom. Scutum was eroded in 23 cases. Malleus (18 cases) is the most commonly eroded among the ossicles. Mastoiditis and mastoid abscess (22%) was the most common complication of CSOM followed by Malleus head erosion (60%). Intracranial complications like abscess, Dural sinus thrombosis (4%), Facial canal Dehiscence (4%) , Tegmen tympani Erosion (2%). Cochlea erosion, Tegmen mastoideum Erosion, Lateral semicircular canal erosion were not observed in any of the cases. Cholesteatoma were observed in 30 cas...
Advanced medical journal
Background and objectives:To compare the findings of high resolution computed tomography of temporal bone with intraoperative findings of patients suffering from chronic suppurative otitis media. Methods:This is a prospective randomize case study which was conducted on 100 patients complaining from chronic ear discharge and hearing impairment. The study was conducted at otolaryngology department, Rizgary Teaching hospital, Erbil City-Iraq from January 2016 to December 2018. The surgical procedures were the same for all patients as mastoid exploration. Based on the intraoperative finding it was decided either to choose canal wall up mastoidectomy or canal wall down mastoidectomy procedure that to be appropriate for particular case with studying and comparing the radiological finding accordingly. Results:Of the 100 patients,47% were males and 53% females. Eighteen cases were diagnosed with cholesteatoma and 82 cases were without. The high resolution computed tomography of temporal bon...
Kathmandu University medical journal, 2017
Background The exact role of High resolution computed tomography (HRCT) temporal bone in preoperative assessment of Chronic suppurative otitis media atticoantral disease still remains controversial. Objective To evaluate the role of high resolution computed tomography temporal bone in Chronic suppurative otitis media atticoantral disease and to compare preoperative computed tomographic findings with intra-operative findings. Method Prospective, analytical study conducted among 65 patients with chronic suppurative otitis media atticoantral disease in Department of Radiodiagnosis, Kathmandu University Dhulikhel Hospital between January 2015 to July 2016. The operative findings were compared with results of imaging. The parameters of comparison were erosion of ossicles, scutum, facial canal, lateral semicircular canal, sigmoid and tegmen plate along with extension of disease to sinus tympani and facial recess. Sensitivity, specificity, negative predictive value, positive predictive val...
International Journal of Otorhinolaryngology and Head and Neck Surgery, 2021
Background: Chronic otitis media is a major health problem with significant morbidity. High-resolution computed tomography (HRCT) is extremely useful for middle ear pathology and extension of the disease. The objective was to study the correlation between preoperative HRCT and intraoperative findings in chronic suppurative otitis media (squamous type).Methods: This analytical study included 61 cases of chronic otitis media (squamous type). Preoperative HRCT findings were correlated with intraoperative findings. Sensitivity, specificity, PPV, NPV and kappa value were estimated.Results: Out of 61 cases 32 were males and 29 were females. Presence of cholesteatoma found on HRCT with 80% sensitivity with k value 0.83 suggesting very good agreement. About ossicular status k value of incus, malleus and stapes were 0.76, 0.65 and 0.54 respectively with sensitivity of 91%, 85% and 58% respectively. Other critical areas on HRCT like sigmoid sinus plate erosion, tegmen tympani dehiscence, scut...
Role of Computed Tomography in diagnosis of complications in chronic suppurative otitis media
Annals of Tropical Medicine and Public Health, 2019
Chronic otitis media is chronic inflammation of middle ear cavity, it present with longstanding discharging ear and perforated tympanic membrane with or without cholesteatoma and other complications. Cross sectional study was performed to identify the role of computed tomography in diagnosis of complications in chronic suppurative otitis media among 40 patients between June 2018 and June 2019. Aim: To identify role of CT scan in diagnosis of anatomical and pathological effects of chronic suppurative otitis media as: pneumatisation of mastoid, soft tissue mass in middle ear cleft and mastoid, cholesteatoma, bones erosions, facial nerve canal dehiscence, labyrinthine and semicircular canal fistula.Patient and Methods: 40 patients included in our study between period June 2018 to June 2019, they are referred from otology department to radiology department in AL Hillah General Teaching Hospital that thin slices CT temporal bone was taken for all these patients. Results: Age incidence: between 15-20 years was 3 of 40 patients (7.5%), 20-40 was 25 (62.5%), 40-50 was 12 0f 40 patients (30%). Mean age is 32.77 years. 16 of 40 patients were female (40%), 24 of 40 patients were male (60%).Male to female ratio 1.5:1. Incidence of symptoms and signs was: headache & pain in 6 patients (15%), vertigo in 5 (12.5%), hearing loss in 30 (75%), discharging ear in 40 (100%), and facial palsy in 2 (5%). Pathology in middle ear: Granulation in 20 cases (50%), cholesteatoma in 15 (37.5%), and polyp in 5 (12.5%). Pneumatisation of mastoid bone: well in 25 cases (62.5%), sclerotic in 13 (32.5%), and poor in 2 (5%). Middle ear and mastoid mass: in CT scan 25 cases (62.5%) and in surgery 24 (60%). Cholesteatoma incidence: in CT scan 15 cases (37.5%) and in surgery 15 (37.5%). Incidence of complications: scutum erosion in CT 14 (35%) in surgery 15 (37.5%), ossicular erosion in CT 11 (27.5%), in surgery 8 (20%), facial canal dehiscence in CT 2 (5%), in surgery 3 (7.5%), labyrinthine fistula in CT 2 (5%), in surgery 1 (2.5%), semicircular canal fistula in CT 3 (7.5%), in surgery 2 (5%), tegument erosion in CT 1 (2.5%), in surgery 2 (5%), and tegument tympani erosion in CT 1 (2.5%) in surgery 1 (2.5%).
European Archives of Oto-Rhino-Laryngology, 2012
The objective of the study was to evaluate the accuracy of the preoperative radiological assessment regarding 10 diVerent middle ear structures in patients with chronic otitis media (COM). The setting of the prospective study was in a Tertiary university hospital. Fifty patients scheduled for a primary operation for COM. All patients underwent preoperative temporal bone high-resolution CTscan (HRCT). AC 1 -statistics between the radiological report and the intra-operative Wndings were calculated. There was no correlation between the radiological assessment and the surgical Wndings in the scutum, attic area, and oval window. There was a poor or fair agreement on the condition of the malleus-incus complex, the status of the tympanic cavity, and the round window. There was a moderately strong agreement regarding the status of the lateral semicircular canal (LSCC) and tegmen tympani. This agreement was primarily observed, when no erosion/exposure was present in the LSCC or the dura. There was a very strong agreement in the mastoid air-cell complex and the sigmoid sinus, especially when the former was abnormal and the latter had no pathology. There are signiWcant diYculties in radiological imaging for reliably assessing the middle ear in patients with chronic otitis media, using HRCT. The preoperative CT scan generally underestimates the actual pathology found by the surgeon in certain middle ear areas. The decision for surgical intervention should not be based on the radiological interpretation of certain middle ear structures, and ENT surgeons should be prepared to encounter conditions which are not reported by the radiologist preoperatively, and modify the operating strategy accordingly. EBM level: 2c.
IOSR Journals , 2019
Introduction :Chronic Suppurative Otitis Media is defined as a chronic inflammation of the middle ear and mastoid cavity. It is classified into 1) inactive mucosal disease, 2) active mucosal disease, 3) inactive squamosal disease, 4) active squamosal disease, 5) healed chronic otitis media. Chronic otitis media with cholesteatoma is a locally invasive disease that requires surgical intervention for definitive eradication of the disease. High resolution CT Scans are widely used to 1) understand the anatomic information, 2) know the extent of disease, 3) relationship of destruction to the anatomical structures. Aims and Objectives: To identify high resolution computed tomography (HRCT) scan findings of temporal bone in chronic inflammatory diseases of the middle ear ,to identify preoperative findings and to evaluate any correlation between scan findings and surgical and functional outcome of the surgery. Materials and methods: This study was conducted on a group of 50 patients with Chronic Otitis Media. A thorough ENT clinical and otoscopic examination was done on all patients. HRCT scan was ordered and interpreted for all the patients. Surgical intervention was done. Post-operatively all the patients were subjected to pure tone audiometry and Health related Quality of Life Questionnaire in the pre and post operative period after 3 months to evaluate functional outcome. Results: It was observed that 32% of the patients were aged between 11-20 years, male to female ratio was 2.1 : 1, erosion of the head and the handle of malleus were found in 34% and 10% on HRCT scan respectively. Incus body and the long process were found to be eroded in 26% and 62% of cases on HRCT scan and stapes suprastructure was found eroded in 36% of cases on HRCT scan. Conclusion: This study supports the role of HRCT scan in all cases of chronic suppurative otitis media to know the status if ossicular chain for the best treatment strategy.