Evaluation of chronic otitis media using computed tomography of temporal bone
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https://doi.org/10.52783/jns.v14.1759Keywords:
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Introduction: Chronic otitis media is a inflammatory condition of middle ear, which is treated by appropriate surgery. Prior to surgery to evaluate extent of disease, complications and anatomical variation is essential. Our study is to determine the reliability of HRCT temporal bone for this purpose.
Methodology: Chronic otitis media patients attending ENT OPD who underwent HRCT temporal bone and treated surgically were taken in the study after obtaining informed consent with the clearance of Institutions Ethical committee.
Results: HRCT exhibited excellent sensitivity and specificity in identifying different abnormalities within the temporal bone, including erosion of the scutum and malleus, mastoiditis, and mastoid abscess, achieving 100% sensitivity and specificity. Moreover, it demonstrated high sensitivity in detecting cholesteatoma across various regions of the middle ear and mastoid, with a sensitivity exceeding 80%. Nevertheless, its sensitivity varied depending on the complication, with facial canal dehiscence and tegmen erosion showing 100% specificity but lower sensitivity for other complications.
Discussion: Similar results with other studies were found and has shown HRCT as a reliable investigation for preoperative evaluation.
Conclusion: HRCT showed high sensitivity and specificity in identifying different abnormalities within the temporal bone. To make a more valid comparison with the conventional research, another population-based study with a longer length Interval is required.
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Gerami H, Naghavi E, Wahabi-Moghadam M. Forghanparus K. Akbar MH. Comparison of pre-operative computerized tomography scan imaging of temporal bone with the intra-operative findings in patients undergoing mastoidectomy. Saudi Med J. 2009 Jan;30(1):104-8
Paparella MM, Kim CS. Mastoidectomy update. Laryngoscope 1977;87:88.
Petros V. Vlastarakos, Catherine Kiprouli, Sotirios Pappas, John Xenelis Paul Maragoudakis, George Troupis, et al. CT scan CT scan versus surgery: how reliable is the pre-operative radiological assessment in patients with chronic otitis media? Eur Arch Otorhinolaryngol 2021 Apr;269:81-6.
Karki S, Pokharel M, Suwal S, Poudel R. Correlation between Preoperative High Resolution Computed Tomography (CT) Findings with Surgical Findings in Chronic Otitis Media (COM) Squamosal Type. Kathmandu Univ Med J (KUMJ). 2017 Jan.-Mar.;15(57):84-87.
Himi T, Sakata M, Shintani T. Mitsuzawa H, Kamagata M, Satoh J, Sugimoto H. Middle ear imaging using virtual endoscopy and its application in patients with ossicular chain anomaly. ORL J Otorhinolaryngol Relat Spec. 2000 Nov-Dec;62(6):316-20. doi: 10.1159/000027776. PMID: 11054015.
Lane JI, Lindell EP, Witte RJ, DeLone DR, Driscoll CL.. Middle and inner ear: improved depiction with multiplanar reconstruction of volumetric CT data. Radiographics. 2006 Jan-Feb;26(1):115-24. doi: 10.1148/rg.261055703.
Chee NW, Tan TY. The value of pre-operative high resolution CT scans in cholesteatoma surgery. Singapore Med J. 2001 Apr;42(4):155-9.
Ranga Reddy Sirigiri, Dwarakanath K. Correlative Study of HRCT in Attico-Antral disease. Indian J Otolaryngol Head Neck Surg 2011 Apr- Jun;63(2):155-8.
Walshe P. Mc Conn Walsh R. Brennan P. Walsh M. The role of computerized tomography in the pre-operative assessment of chronic suppurative otitis media. Clinico Otolarngol allied Sci 2002 Apr;27(2):95-7.
Gerami H, Naghavı E Comparison of pre-operative computed tomography scan imaging of temporal bone with the intra-operative finding in patient undergoing mastoidectomy. Saudi Med J 2009 Jan;30(1):104-8.
Garber LZ, Dort JC. Cholesteatoma: diagnosis and staging by CT scan. J Otolaryngol 1994 Apr;23(2):121-4.
Mafee MF, Levin BC, Applebaum EL, Campos M, James C. Cholesteatoma of the middle ear and mastoid. A comparison of CT scan and operative findings. Otolaryngol Clin North Am. 1988;21(2):265-93.
OReilly BJ, Chevretton EB, Wylie I, Thakkar C, Butler P, Sathanathan N, et al. the value of CT scanning in chronic suppurative otitis media. J Laryngol Otol 1991 dec;105(12):990-4.
ODonoghue GM. Cholesteatoma: diagnosis and staging by CT scan. J Otolaryngol 1987;12:157-60.
Firas Q Alzoubi, Haaitham A Odat, Hassan A Al-balas, Saeed SR. The role for preoperative CT scan in patients with chronic otitis media European Archives of Oto-rhino-Laryngology 2009 Jun;266(6):807-9.
Gaurano JL, Joharjy IA. Middle ear cholesteatoma: characteristic CT findings in 64 patients. Ann Saudi Med 2004 Nov-Dec;24(6):442-7.
Rocher P, Carlier R, Attal P, Doyon D, Bobin S. Contribution and role of the scanner in the preoperative evaluation of chronic otitis. Radiosurgical correlation apropos of 85 cases. Ann Otolaryngol Chir Cervicofac 1995; 112(7):317-23.
Zhang X, Chen Y, Lui Q, Han Z, Li X. CT scan versus surgery: how reliable is the pre-operative radiological assessment in patients with chronic otitis media? Lin Chuang El Bi Yan Hor He Za Zhi 2004 Jul; 18(7):396-8.
Schwartz JD. High-resolution computed tomography of the middle ear and mastoid. Part 1: Normal radioanatomy including normal variations. Radiology 1983;148(2):449-54.
Zelikovich El. CT temporal bone in diagnosis of otitis media chronic purulent. Vestn Otolaryngol 2004;4:25-9.
Lui Zhaohui, Wang Zhenchang, Xian Junfang, Zhao Kun, Zhang Hong. HRCT study of anatomic variation of temporal bone. Chinese archives of Otolaryngology- Head and Neck Surgery 2006;2:97-101.
Tomura N, Sashi R, Kobayashi M, Hirano H, Hashimoto M, Wtaraj J. Normal variations of the temporal bone on high resolution CT: their incidence and clinical significance. Clin Radiol 1995 Mar;50(3):144-8.
Magliulo G. Colicchio MG, Ciniglio M. Facial nerve dehiscence and cholesteatoma, Ann Otol Rhinol Larynx 2011 April;120(4):261-7.
Suat Keskin, Huseyin Cetin, Huesyin Gurkan Tore. The correlation of temporal bone CT with surgery findings in evaluation of chronic inflammatory diseases of the middle ear. Eur J Gen Med. 2011;8(1):24- 30.
Ghodrat Mohammadi, Masoud Naderpour, Mehrnoosh Mousaviagdas Ossicular erosion in patients requiring surgery for cholesteatoma. Iranian Journal of Otorhinolaryngology 2012;24(3):125-8.
Garap JP, Dubey SP. Canal-down mastoidectomy: experience in 81 cases. Otoneurotol 2001; 22:451-6
Ashwani Sethi, Ishwar Singh, Agarwal AK, Deepika Sarren. Pneumatization of mastoid air cell: Role of acquired Factors. Int J Morphol 2006, 24(1):35-8.
Park K. Screening for disease. 20th ed. Chapter 4. In Parks Textbook of Preventive and Social Medcine;2009.pp.127-8.
Majeed J, Sudarshan Reddy L. Role of CT Mastoids in the Diagnosis and Surgical Management of Chronic Inflammatory Ear Diseases. Indian J Otolaryngol Head Neck Surg. 2017 Mar;69(1):113-120. doi: 10.1007/s12070-016-1023-z.
Abdul. Rahim Ahmed Abdel. Kamin, Hosny said Abdel KHany. Mohmed Abdel Motal Gomma, Ahmed Abdel Kader El-Hene, Ahmed Adel Sadek. Radiological evaluation of middle ear cholesteatoma otitis. El-minia Med, Bul 2010 Jan;21(1):66-74.
Leskinen K. Jero J. Acute complications of otitis media in adults. Clinical Otolaryngology 2005 Dec;30(6):511-6.
Singh R, Rai R, Singh P, Sethi S, Ahluwalia APS, Choudhary G. High- resolution computed tomography (HRCT) in pediatric and adult patients with unsafe chronic suppurative otitis media (CSOM) and its surgical correlation. J Family Med Prim Care. 2020 Aug 25,9(8):4067-4073 10.4103/jfmpc.jfmpc_455_20. doi:
Bathla M, Doshi H, Kansara A. Is Routine Use of High Resolution Computerized Tomography of Temporal Bone in Patients of Atticoantral Chronic Suppurative Otitis Media without Intracranial Complications Justified? Indian J Otolaryngol Head Neck Surg. 2018 Mar;70(1):79-86. doi: 10.1007/s12070-017-1103-8,
Mandal S, Muneer K, Roy M. High Resolution Computed Tomography of Temporal Bone: The Predictive Value in Atticoantral Disease. Indian J Otolaryngol Head Neck Surg. 2019 Nov;71(Suppl 2):1391-1395. doi: 10.1007/s12070-018-1465-6.
Manik S, Dabholkar Y, Bhalekar S. Velankar H, Chordia N, Saberwal A. Sensitivity and Specificity of High-Resolution Computed Tomography (HRCT) of Temporal Bone in Diagnosing Cholesteatoma and Its Correlation with Intraoperative Findings. Indian J Otolaryngol Head Neck Surg. 2021 Mar;73(1):25-29. doi: 10.1007/s12070-020- 01892-z.
Rogha M, Hashemi SM, Mokhtarinejad F. Eshaghian A, Dadgostar A. Comparison of Preoperative Temporal Bone CT with Intraoperative Findings in Patients with Cholesteatoma. Iran J Otorhinolaryngol. 2014 Jan;26(74):7-12.
Mehanna AM, Baki FA, Eid M. Negm M. Comparison of differnat computed tomography post-processing modalities in ment of various middle car disorders. Eur Arch Otorhinolaryngol 2015 Jun 272(6):1357-70. doi: 10.1007/s00405-014-2020-y. Epub 2014 Fish 15.
Blom EF, Gunning MN, Kleinrensink NJ, Lokin AS, Bruijnzeel 11. Smit AL, Grolman W Influence of Ossicular Chain Damage on Hearing After Chronic Otitis Media and Cholesteatoma Surgery: A Systematis Review and Meta-analysis. JAMA Otolaryngol Head Neck Surg. 2015 Nov: 141(11):974-82.doi: 10.1001/jamaoto 2015.2269.PMID: 26502037
Martin TP, Weller MD, Kim DS, Smith MC. Results of primary ossiculoplasty in ears with an intact stapes superstructure and malleus handle: inflammation in the middle car at the time of surgery does not affect hearing outcomes. Clin Otolaryngol. 2009 Jun:34(3):218-24, dol 10.1111/j.1749-4486.2009.01929.x. PMID: 19531170
Buckingham RA, Valvassori GE, Tomographic and surgical pathology of cholesteatoma. Arch Otolaryngol 1970:91:464-9
Proctor B. Chronic otitis media and mastoiditis. In: Paparella MM Shumrick DA, editors. Otolaryngology (Otology and Neurotology) 3rd ed., Vol. 2. Philadelphia: WB Saunders, 1980. p. 1366
Bluestone CD, Klein JO. Intracranial complications and sequelae of otitis media. In: Bluestone CD, editor. Paediatric Otolaryngology 2nd ed., Vol. 1 Philadelphia: WB Saunders, 1990. p. 738-40.
Ragavoodoo S. Agarwal MK, Srivasatava A. A comparative study between preoperative CT scan findings and operative findings in cholesteatoma of the middle ear cleft. Indian 1 Otolaryngol Head Neck Surg 2005 Special issue.
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