Evaluation and significance of Eustachian tube angles and pretympanic diameter in HRCT temporal bone of patients with chronic otitis media

BACKGROUND Chronic otitis media (COM) of squamosal type is associated with cholestatoma with potential complications. Clinical examination and high resolution computed tomography (HRCT) scans are necessary to assess the disease site and extension. The purpose of the study was to compare the preoperative HRCT findings with the intraoperative surgical findings in squamosal type of chronic otitis media as well as various parameters in HRCT temporal bone and intraoperative findings. METHODS A prospective study was conducted on 30 patients aged between 18 and 60 years of both the genders who presented with chronic otitis media squamosal type, for a period of 22 months who attended the outpatient department of ENT. RESULTS HRCT findings and intraoperative findings were compared and results were analysed. Facial canal erosion (P - 0.0031), tegmen plate erosion (P - 0.0001), sigmoid sinus plate erosion (P - 0.002) were found to be statistically significant. Lateral semicircular canal fistula (P - 0.36) and ossicular status malleus (P - 1.000), incus (P - 0.949), stapes suprastructure (P - 0.984), and stapes footplate erosion (P - 0.977) were found to be statistically insignificant. CONCLUSIONS In our study, HRCT imaging for COM squamosal type, accurately depicted the soft tissue mass, erosion of tegmen plate, sigmoid sinus plate, scutum, lateral semicircular canal fistula, incus and suprastructure of stapes erosion and the same were found intraoperatively as well. Our study showed good comparison between the preoperative HRCT scans and the surgical findings in cholesteatoma cases. HRCT is confirmed to be valuable in the diagnosis and in guiding the surgical management of cholesteatoma. KEY WORDS Chronic Otitis Media, Cholesteatoma, HRCT Temporal Bone, Modified Radical Mastoidectomy

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Comparative evaluation of mastoid pneumatization pattern using X-ray mastoid and high-resolution computed tomography temporal bone in unilateral squamosal chronic otitis media

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20203197 ◽

2020 ◽

Vol 6 (8) ◽

pp. 1469

Author(s):

Akanksha Dhiman ◽

Ankur Gupta ◽

Nishi Sharma ◽

Akhilandeswari Prasad

Keyword(s):

Computed Tomography ◽

High Resolution ◽

Temporal Bone ◽

Otitis Media ◽

Chronic Otitis Media ◽

Anatomical Variations ◽

High Resolution Computed Tomography ◽

Mastoid Pneumatization ◽

X Ray ◽

Hrct Temporal Bone

Background: Chronic otitis media (COM) affects 0.5-30% of individuals in any community and over 20 million people are estimated to suffer from this condition worldwide. COM often evolves in a continuum. Squamosal disease is more commonly found in poorly pneumatized bones, but whether the sclerosis is relevant to the etiology of the disease or is caused by it, has not been fully resolved. Our study aimed at comparing the mastoid pneumatization patterns obtained using X-ray mastoid and high-resolution computed tomography (HRCT) temporal bone. It was an interventional study.Methods: Sixty patients of unilateral squamosal COM, aged more than 8 years, underwent X-ray mastoid Schuller’s view and HRCT temporal bone, using Philips extended brilliance 48 slice CT. Results: Upon analysis, in diseased and healthy ears, the coincidence of X-ray and HRCT findings was 63.33% and 80% respectively.Conclusions: HRCT temporal bone should be done in all cases of squamosal COM to know the extent of the disease, pneumatization patterns and the presence of anatomical variations.

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Is HRCT Temporal Bone Necessary in All Cases of Active Squamous Chronic Otitis Media?

Indian Journal of Otolaryngology and Head & Neck Surgery ◽

10.1007/s12070-018-1272-0 ◽

2018 ◽

Vol 71 (S2) ◽

pp. 1212-1216 ◽

Cited By ~ 2

Author(s):

Md Izhar Khan ◽

Seema Patel ◽

Kalpana Dasgupta

Keyword(s):

Temporal Bone ◽

Otitis Media ◽

Chronic Otitis Media ◽

Hrct Temporal Bone

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The Value of Measuring Eustachian Tube Aeration on Temporal Bone CT in Patients with Chronic Otitis Media

Clinical and Experimental Otorhinolaryngology ◽

10.3342/ceo.2010.3.2.59 ◽

2010 ◽

Vol 3 (2) ◽

pp. 59 ◽

Cited By ~ 9

Author(s):

Hyun Joon Shim ◽

A Young Choi ◽

Sang Won Yoon ◽

Kee Hwan Kwon ◽

Seung Geun Yeo

Keyword(s):

Temporal Bone ◽

Otitis Media ◽

Eustachian Tube ◽

Chronic Otitis Media ◽

Temporal Bone Ct

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A study of the correlation between the pre-operative high resolution computed tomography findings and intra-operative findings in chronic otitis media-squamosal type

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20200056 ◽

2020 ◽

Vol 6 (2) ◽

pp. 273

Author(s):

Gopinathan N. Pillai ◽

Anjana Mary Reynolds ◽

Melwin Tom

Keyword(s):

Computed Tomography ◽

High Resolution ◽

Temporal Bone ◽

Otitis Media ◽

Chronic Otitis Media ◽

Hearing Preservation ◽

High Resolution Computed Tomography ◽

Surgical Methods ◽

Hrct Temporal Bone ◽

Operative Findings

Background: Chronic otitis media (COM) is characterized by ear discharge and hearing loss. There are two types of COM depending on the presence or absence of cholesteatoma. COM with cholesteatoma is termed as COM squamosal type and COM without cholesteatoma is termed COM mucosal type. COM squamosal type is associated with potential complications. If cholesteatoma is detected early, less invasive surgical methods can be used for hearing preservation and make ear safe from recurrent infections. A proper clinical examination can most often diagnose a cholesteatoma but require a high resolution computed tomography (HRCT) scan to assess the extent of the disease and potential complications. But most often the intra operative findings may not correlate with the HRCT findings. The aim of the study was to evaluate the clinical presentation of COM squamosal disease, preoperative HRCT and intra-operative findings and formulate a proper surgical intervention to avoid complications. Methods: This is a comparative study of the pre-operative HRCT and intra-operative findings in COM squamosal type. In the present study of 35 patients with squamosal disease, the HRCT findings were compared with intra-operative findings.Results: The study showed a good correlation between pre-operative HRCT of temporal bone and intra operative finding. The findings are statistically significant (p<0.001).Conclusions: The study shows a good correlation between pre-operative HRCT temporal bone and intra-operative findings.

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Role of HRCT Temporal Bone in Pre-operative Assessment of Tegmen Height in Chronic Otitis Media Patients

Journal of Clinical Imaging Science ◽

10.25259/jcis_131_2020 ◽

2020 ◽

Vol 10 ◽

pp. 79

Author(s):

Mushahid Husain ◽

Sachin Khanduri ◽

Syed M. Faiz ◽

Syed Zain Abbas ◽

Poonam Yadav ◽

...

Keyword(s):

Temporal Bone ◽

Otitis Media ◽

Chronic Otitis Media ◽

Diagnostic Efficacy ◽

Significant Difference ◽

The Mean ◽

Hrct Temporal Bone ◽

Sensitivity Specificity ◽

Operative Assessment

Objectives: High-resolution CT (HRCT) temporal bone has emerged as a useful option in pre-operative assessment of tegmen height in chronic otitis media patients. Material and Methods: A total of 60 patients with clinical suspicion of chronic otitis media were enrolled in the study. HRCT evaluation was done using Siemens Somatom Force 384 slice multidetector computed tomography machine. We radiologically assess tegmen height using lateral semicircular canal as a reference point on HRCT. Final result has been based on correlation of radiological and intraoperative findings. Diagnostic efficacy of HRCT temporal bone was evaluated in terms of sensitivity, specificity, PPV, NPV, and accuracy for pre-operative assessment of tegmen height. Results: The correlation between actual tegmen height and estimated tegmen height (by equation) was 0.457 which is highly significant (P < 0.001). In the study, the mean tegmen height of exposed dura (ED) was 5.81 ± 1.71 (95% CI 4.91–6.70) while the mean tegmen height of non-exposed dura (NED) was 8.40 ± 1.31 (95% CI 8.02– 8.78). Highly significant difference was found in mean tegmen height between ED and NED cases (P < 0.001). Conclusion: Pre-operative CT assessment of tegmen height is an important parameter in assessing risk of dural injury during tympanomastoid surgeries.

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