The Correlation of Temporal Bone CT With Surgery Findings in Evaluation of Chronic Inflammatory Diseases of The Middle Ear (original) (raw)
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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...
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.
Chronic inflammatory middle ear disease: Postoperative CT and MRI findings
The Egyptian Journal of Radiology and Nuclear Medicine, 2015
To prospectively evaluate the value of CT and MRI in diagnosis of middle ear pathologies following operation for chronic otitis media (COM). Patients and methods: Fifty patients, who had been operated on for chronic middle ear disease, were referred for either CT alone or followed by MRI depending on the different case scenarios. Imaging findings were correlated with surgical findings. Results: CT alone was done in 10 patients; 6/10 showed a free mastoidectomy cavity and 4/10 showed a clear cavity with abnormal position of the prosthesis. The rest of the 40 patients did a CT followed by MRI which showed granulation tissue in 17 patients, cholesteatoma in 13/14 patients of which one showed intracranial extension, combined granulation tissue with cholesteatoma in 5/6 patients, cholesterol granuloma in 2 patients and meningocele in another 2 patients. Overall CT sensitivity and specificity was 46.25% and 90.77% and MRI sensitivity and specificity was 95.23% and 99.16% respectively. Conclusion: CT and MRI are both safe non-invasive diagnostic methods. Both procedures can provide radiologists a confident diagnosis of postoperative middle ear complications, assisting otologists with a provisional diagnosis for a better management.
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%).
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...
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...
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...
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.
Journal of Evolution of Medical and Dental Sciences
High Resolution Computed Tomography (HRCT), a modification of routine CT, provides a direct visual window in the temporal bone providing minute structural details. Purpose of the present study was to evaluate the suppurative diseases of middle ear and mastoid with their complications on HRCT and to correlate these imaging findings surgically. Our study shows good correlation of various HRCT findings in suppurative diseases of middle ear & mastoids with intra-operative findings. MATERIALS AND METHODS This retrospective study included 60 patients who were referred to the Department of Radiodiagnosis, Assam Medical College with clinically suspected temporal bone or ear pathologies. After detailed clinical examination, the patients were subjected to HRCT examination. The imaging findings of all cases were correlated with the surgical findings. RESULTS Out of 60 patients, 63.3% had unsafe CSOM with cholesteatoma. The HRCT findings with surgical correlation showed a high 91.89% sensitivity for identifying cholesteatoma. HRCT also provided good sensitivity for detecting erosion of scutum (90.32%), erosion of ossicular chain (86.96%) and erosion of lateral semi-circular canal (80%). HRCT had lower sensitivity (66.67%) for identifying facial canal dehiscence. CONCLUSION The HRCT findings showed a good sensitivity with intraoperative findings in identification of cholesteatoma, erosion of scutum, ossicular chain and semi-circular canal.
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.