Usefulness of CT scans in malignant external otitis: effective tool for the diagnosis, but of limited value in predicting outcome (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.
ROLE OF HIGH RESOLUTION COMPUTED TOMOGRAPHY IN THE EVALUATION OF TEMPORAL BONE LESIONS
Asian Journal of Pharmaceutical and Clinical Research Journal, 2022
Objectives: The study's primary goal is to assess inflammatory, traumatic, and neoplastic disorders that impact the temporal bone using high resolution computed tomography (HRCT). The other aim is to comprehend how HRCT can diagnose and detect pathologies of the temporal bone. Methods: The study was conducted at Dr. Patnam Mahender Reddy Institute of Medical Sciences from Jan 2018 to Jan 2020 with a sample size of 60. Written consent for participation in the study was taken before the scan. The study was evaluated with multidetector HRCT-HITACHI 128 SLICE machine. CT images are usually acquired or displayed in axial and coronal planes. Results: Among 60 patients, 44 patients were diagnosed with infections, 11 were diagnosed with tumors, and five patients with anatomical variants. Among 60 patients, 32 (53.3%) were male patients, and 28 (46.6%) were female patients; hence, study shows a male preponderance. Out of 60 patients, the highest number was recorded in those aged 21-30 years 16 (36%). Among 60 patients, 44 suspected of having a middle ear infection were studied. Among these 44 patients, 27 (61.3%) were diagnosed with otomastoiditis, 16 (36%) patients were diagnosed with cholesteatoma, and 1 (2.2%) patient was diagnosed with malignant otitis externa. In our study population of 60 patients, 11 were diagnosed with neoplasms. Among the 11 patients, 7 (67%) were diagnosed with acoustic neuroma in the cerebellopontine angle. Conclusion: The existence of cholesteatoma, changes to the ossicular chain, and erosion of the lateral semicircular canal were all intraoperatively detected in the present study with excellent sensitivity to the clinical and radiographic findings. For correcting any congenital ear anomalies, the HRCT results were helpful for planning and management tools for the surgeon.
Analytical Study of Temporal Bone Pathologies and Anatomical Variations on High Resolution CT
Asian Journal of Medical Radiological Research, 2019
Background: High Resolution Computed Tomography (HRCT), a modification of routine CT, owing to its ability to delineate intricate osseous anatomy and admirable topographic visualization, is widely used for accurate assessment of temporal bone pathologies prior to surgical exploration. The present study was undertaken to evaluate temporal bone in diseased ears by HRCT and its importance in patient management. Subjects and Methods: This prospective study was conducted in the department of Radiodiagnosis of a large tertiary care hospital in Northern India. A total of 50 patients with clinically proven middle ear disease with hearing loss or chronic suppurative otitis media (CSOM) were enrolled into this study. All cases were evaluated with 128 slice CT scanner (Philips Medical systems, Cleveland, USA). Results: Mean age of patients in our study was 29.52 ± 21.48 years. Maximum patients with temporal bone pathologies had either sclerosed or under-pneumatized mastoids. Limited numbers of anatomical variations were noted with Korner's septum being the most common variation (7.14 %). Others variations included high jugular bulb (2.86 %), facial nerve dehiscence (2.86 %), labyrinthine fistula (2.86 %) and foramen tympanicum (1.43 %). Otomastoiditis was the most frequently encountered pathological condition in the study population (72.86 %), followed by cholesteatoma (32.86 %). Congenital malformations were seen in 10 cases (14.29%) with type I incomplete partition (5.71%) being the most common malformation. Conclusion: HRCT of temporal bone is useful in identifying common ear pathologies and anatomical variations prior to the surgery and thereby planning appropriate surgical approach.
An Exploratory Study of High Resolution Computed Tomography of Temporal Bone in Chronic Otitis Media
Nepalese Journal of Radiology
Introduction: Among various modalities used in the evaluation of chronic otitis media, HRCT of the temporal bone is the most reliable and valuable imaging modality as it provides excellent anatomic information. It can display minute anatomical and pathological details by providing a direct visual window into the temporal bone. Methods: This is a prospective cross-sectional study done at the department of Radiodiagnosis and imaging of Birat Medical College, Teaching hospital over 1 year with a total of 50 patients enrolled in the study. The findings were compared with the post-operative findings and data were entered. HRCT was done on 64 slices of multidetector CT scan. Sensitivity, specificity, positive predictive value, negative predictive value and accuracy of various parameters were calculated. Results: Out of 50 patients were enrolled in this study. Among them 52%(26) were females and 48%(24) were males. HRCT showed 100% sensitivity for the lateral semicircular canal and sigmoid...
© American Society of Neuroradiology CT of the Temporal Bone in
1987
In an attempt to better define the changes affecting the temporal bone that might predispose achondroplastic dwarfs to otitis media, nine achondroplastic subjects who were evaluated for hearing loss underwent high-resolution CT scanning of the temporal bone. Comparisons were made with 10 nonachondroplastic subjects. A number of morphologic changes were seen, including (1) poor development of mastoid air cells, (2) foreshortening of the carotid canals, (3) narrowing of the skull base, (4) "towering" petrous ridges, and (5) relative "rotation " of the cochlea and other temporal bone structures. The most significant change was the rotational effect, which was more pronounced medially, resulting in an abnormal orientation of inner ear structures relative to middle ear structures and of middle ear structures relative to the external auditory canal. There was a notable lack of evidence for otitis media or its sequelae in any of the achondroplastic subjects. Audiograms ...
High resolution multi detector computed tomography (HRMDCT) is an excellent tool for evaluation of a variety of congenital and acquired conditions affecting the temporal bones. We describe our experience of HRMDCT of temporal bones of 145 patients in a tertiary care and teaching hospital of Armed Forces Medical Services of India over a period of three and half years. Hearing loss was the most frequent indication for HRMDCT and congenital bilateral profound sensorineural hearing loss for evaluation prior to possible cochlear implant formed the single largest group (62, 42%) among all indications for HRMDCT of temporal bones. Major vestibule-cochlear and semicircular canal anomalies were noted in 11 such cases. Seven patients of microtia were studied and all had positive CT scan findings. All patients of vertigo had normal HRCT study. Extent of temporal bone injuries and inflammatory conditions were clearly delineated in all cases. Thinner collimations allowing image reconstructions in planes of anatomical interest with near isotropic resolution has been a major advantage of HRMDCT of temporal bones.
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.