scholarly journals Role of high resolution computed tomography of temporal bone in preoperative evaluation of chronic suppurative otitis media

2018 ◽  
Vol 4 (5) ◽  
pp. 1287 ◽  
Author(s):  
M. D. Prakash ◽  
Afshan Tarannum
Keyword(s):  
Temporal Bone ◽  
Otitis Media ◽  
Sensitivity And Specificity ◽  
Middle Ear ◽  
Preoperative Evaluation ◽  
High Sensitivity ◽  
Chronic Suppurative Otitis Media ◽  
High Resolution Computed Tomography ◽  
Suppurative Otitis Media ◽  
Middle Ear Cleft

<p class="abstract"><strong>Background:</strong> Chronic suppurative otitis media (CSOM) is a common condition seen in patients attending ENT department. The diagnosis of cholesteatoma is usually made on otologic examination. The necessity for HRCT imaging in an uncomplicated case is controversial. The objective was<strong> </strong>to evaluate preoperative HRCT temporal bone and to determine its’ usefulness in patients with Chronic suppurative otitis media (CSOM) undergoing surgery.</p><p class="abstract"><strong>Methods:</strong> This study was a prospective study involving 30 cases of CSOM with cholestaetoma. All the patients underwent pre-operative HRCT screening followed by surgical exploration of middle ear cleft. Pre-operative CT scan and intra-operative findings recorded and compared.  </p><p class="abstract"><strong>Results:</strong> Out of total 30 patients of CSOM, 16 (53%) were males and (90%) presented with chief complaints of otorrhoea. HRCT scan was found to be very sensitive (100%) in detecting cholesteatoma in middle ear cleft but differentiation between granulations or cholesteatoma wasn’t possible. HRCT satisfactorily delineated ossicular erosion except stapes suprastructure erosion which had 81.8% sensitivity and specificity 88.88%. For bony boundaries of middle ear, HRCT showed very high sensitivity and specificity for detecting scutum erosion, tegmen erosion, mastoid cortex erosion, jugular bulb dehiscence and bony external auditory canal erosion. It was moderately sensitive for LSCC Erosion (75%), Facial canal erosion (80%) and Sinus plate erosion (85.7%).</p><p class="abstract"><strong>Conclusions:</strong> These results indicate that preoperative CT temporal bone scan of patients with CSOM serves as an important guide in surgical approach for otolaryngologists, although there are limitations in evaluation of the CT results.</p>

scholarly journals Radio-surgical correlation of chronic suppurative otitis media

2019 ◽  
Vol 6 (1) ◽  
pp. 118
Author(s):  
Yogeesha B. S. ◽  
Nagaraj Maradi ◽  
Ravi Shekhar ◽  
Rohini D. Urs
Keyword(s):  
Otitis Media ◽  
Middle Ear ◽  
Predictive Value ◽  
Ossicular Chain ◽  
Chronic Suppurative Otitis Media ◽  
High Resolution Computed Tomography ◽  
Suppurative Otitis Media ◽  
Fallopian Canal ◽  
Ear Ossicles ◽  
Kappa Value

<p class="abstract"><strong>Background:</strong> Chronic suppurative otitis media (CSOM) because of disease nature and location of vital structures like middle ear ossicles, facial nerve, and lateral semicircular canal poses clinical as well as radiological challenge in diagnosis, especially the squamosal variety. Hence this study to evaluate radio-surgical correlation in cases of CSOM.</p><p class="abstract"><strong>Methods:</strong> We retrospectively analysed 92 case records who met the inclusion criteria. Their pre-operative high-resolution computed tomography (HRCT) temporal bone imaging was evaluated for erosion of the ossicular chain and the fallopian canal. This was correlated with the surgical findings noted intra-operatively. The appropriate statistical analysis was carried out. The radio-surgical correlation was evaluated by Cohen’s kappa value.  </p><p class="abstract"><strong>Results:</strong> The kappa value for status of ossicular chain was 0.805 and 0.384 for status of fallopian canal. HRCT imaging had a positive predictive value and negative predictive value of 94.3% and 85.3% respectively, in detecting ossicular chain erosion. In detecting fallopian canal erosion, HRCT showed a sensitivity of 33.3%. Analysing the individual ossicles, we found kappa to be 0.266 for malleus, 0.463 for incus and 0.827 for stapes.</p><p class="abstract"><strong>Conclusions:</strong> There was excellent radio-surgical correlation for ossicular chain erosion while it was poor for fallopian canal erosion. HRCT showed excellent radio-surgical correlation for stapes, moderate for incus and poor for malleus. In-spite of its shortcomings in differentiating cholesteatoma and non-cholesteatomatous pathologies of the middle ear cleft, HRCT imaging plays a key role in assessing the status of the ossicles and fallopian canal.</p><p> </p>

Role of high resolution computed tomography of temporal bone in management of chronic suppurative otitis media

2016 ◽  
Vol 2 (4) ◽  
pp. 193
Author(s):  
Jaiprakash Tak ◽  
Ajeet Kumar Khilnani
Keyword(s):  
Computed Tomography ◽  
High Resolution ◽  
Temporal Bone ◽  
Otitis Media ◽  
Tertiary Care ◽  
Disease Process ◽  
Chronic Suppurative Otitis Media ◽  
Care Hospital ◽  
High Resolution Computed Tomography ◽  
Suppurative Otitis Media

<p class="abstract"><strong>Background:</strong> 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.</p><p class="abstract"><strong>Methods:</strong> 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 attico-antral 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.</p><p class="abstract"><strong>Results:</strong> 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.</p><p><strong>Conclusions:</strong> HRCT was helpful in determining the anatomy of the middle ear and mastoid, and accurately predicted the extent of the disease process of CSOM. </p>

scholarly journals Tubotympanic cholesteatoma

2021 ◽  
Vol 16 (3) ◽  
pp. 123-125
Author(s):  
Darshini Nagarajah ◽  
Mohd Khairi Md Daud ◽  
Nur Syazwani Salehuddin ◽  
Nik Adilah Nik Othman
Keyword(s):  
Hearing Loss ◽  
Chronic Inflammation ◽  
Otitis Media ◽  
Middle Ear ◽  
Chronic Suppurative Otitis Media ◽  
Suppurative Otitis Media ◽  
Persistent Disease ◽  
Middle Ear Cleft ◽  
Severe Destruction

Chronic suppurative otitis media is defined as a chronic inflammation of the mucoperiosteal lining of the middle ear cleft. It is described as a persistent disease that is insidious in onset, often capable of causing severe destruction with irreversible sequelae, and clinically present with hearing loss and discharge. It has been classified into tubotympanic (safe) and atticoantral (unsafe) perforation. Cholesteatoma always occur in the atticoantral type and in marginal perforation. We report a case of cholesteatoma that occurred as a tubotympanic type of perforation.

scholarly journals HIGH RESOLUTION COMPUTED TOMOGRAPHY FINDINGS OF TEMPORAL BONE IN PATIENTS WITH UNSAFE CHRONIC SUPPURATIVE OTITIS MEDIA.

2021 ◽  
pp. 1-3
Author(s):  
Sakshi Shami ◽  
Raunaq Raunaq ◽  
Shishir Chumber ◽  
Kavita Vani ◽  
Akhilandeswari Prasad
Keyword(s):  
Temporal Bone ◽  
Middle Ear ◽  
Treatment Plan ◽  
Common Finding ◽  
High Resolution Computed Tomography ◽  
Cross Sectional ◽  
Suppurative Otitis Media ◽  
Scan Time ◽  
Extent Of Disease ◽  
Middle Ear Cleft

CSOM is defined as chronic inflammation of mucoperiosteal lining of middle ear cleft, i.e. eustachian tube, middle ear and mastoid. Unsafe CSOM is associated with marginal/ attic perforations and cholesteatoma, which may produce multiple complications. It is a potentially serious condition as it can progressively enlarge and cause erosion into neighbouring structures, giving rise to serious complications. HRCT provides information regarding the extent of disease and depicts anatomical variations, which may lead to complications during surgery. The aim of this study was to assess the usefulness of HRCT imaging of temporal bone in cases of unsafe CSOM. In an IRB approved cross-sectional observational study of consecutive 50 patients with clinically diagnosed unsafe CSOM, HRCT of temporal bone was performed. Patients not fit for CT scan e.g., pregnant patients were excluded. HRCT was performed on Philips Brilliance 40 slice CT. Collimation was set at 190mm with scan time of 4.79 seconds with kVp of 140 and mAs of 350. HRCT findings of these patients were compared with the intraoperative findings of those patients who underwent surgery. Standardised statistical methods were used. It was found to be male predominant disease with a mean age of 25.5 years. The most common finding on HRCT was soft tissue density involving the middle ear cleft. Cholesteatoma caused ossicular erosion with the incus being most commonly affected. This study concludes that HRCT should be done in all patients of unsafe CSOM to know the extent of disease which guide in surgical approach and treatment plan.

scholarly journals Middle ear cholesteatoma: a study of correlation between HRCT temporal bone and intraoperative surgical findings

2018 ◽  
Vol 4 (5) ◽  
pp. 1252
Author(s):  
Payal S. Chavada ◽  
Paresh J. Khavdu ◽  
Alpesh D. Fefar ◽  
Manish R. Mehta
Keyword(s):  
Temporal Bone ◽  
Otitis Media ◽  
Middle Ear ◽  
Anatomical Variations ◽  
Chronic Suppurative Otitis Media ◽  
Suppurative Otitis Media ◽  
Road Map ◽  
Middle Ear Cholesteatoma ◽  
Hrct Temporal Bone ◽  
A Prospective Study

<p class="abstract"><strong>Background:</strong> Cholesteatoma is a long-standing infection of the middle ear cleft having erosive properties. Chronic ear discharge and decreased hearing are most common clinical presentation. Multi-directional tomography of high quality can provide a detailed understanding of the interpretation of anatomical structures visualized by HRCT. Knowledge of the anatomical variations and changes induced by pathology in the temporal bone are the guiding marbles for surgery.</p><p class="abstract"><strong>Methods:</strong> This is a Prospective study consisted of 100 cases of chronic suppurative otitis media of unsafe type requiring ear surgery admitted in the E.N.T. department of P.D.U. Civil Hospital Rajkot in 2 years from December 2015 to December 2017. A total no. of 100 patients of both gender between 5 to 80 years has been included in the study.  </p><p class="abstract"><strong>Results:</strong> In this study, 58% patients were females while males were 42%. Left ear (46%) was involved more as compared to right ear (40%). Most of the patients belonged to 11-20 (25%) years of age group. mean age is 24.5 years. Most common symptoms were ear discharge (98%) and decreased hearing (83%).</p><p class="abstract"><strong>Conclusions:</strong> HRCT guides the surgeon on the possible surgical hazards before the surgery and helps in earlier management and operative complications. The use of CT in the case of chronic suppurative otitis media does provide valuable information. HRCT scanning is a unique method of detection of early cholesteatoma as well as detection of cho­lesteatoma in hidden areas. In addition, HRCT scanning serves as a road map to assist the surgeon during cholesteatoma surgery.</p>

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