scholarly journals Comparison of preoperative high resolution computerized tomography of temporal bone with intra-operative findings in patients with cholesteatoma

Author(s):  
Abdunnasar Moodem Pilakkal ◽  
Santhi Thankappan Pillai ◽  
Asif Iqbal Kunhanakkal

<p class="abstract"><strong>Background:</strong> Aim was to study the correlation between high resolution computed tomography (HRCT) scan and intraoperative findings during surgery in cases of chronic otitis media with cholesteatoma.</p><p class="abstract"><strong>Methods:</strong> This was a descriptive study conducted on 72 patients with acquired cholesteatoma at Govt TD Medical College, Alappuzha for a period of 18 months. All the patients were subjected to HRCT of the temporal bone. Radiological correlation was done with the intra-operative findings. Sensitivity, specificity, positive and negative predictive values were calculated.   </p><p class="abstract"><strong>Results:</strong> Total 24 (33.3%) patients had holotympanic cholesteatoma, 21 (29.2%) had involvement of the attic alone and 16 (22.2%) had attic and antrum involved. 100% correlation was found with bony wall erosions, whereas 96.9% and 75% sensitivity were noted in incus and stapes erosions respectively. 100% specificity was obtained in facial canal and sinus plate erosion, while a specificity of 96.9% in tegmen erosion and 98% in were seen in malleus erosion. By chi square test the difference in correlation was not significant (p value&gt;0.01). Good correlation was seen for lateral semicircular canal fistula. Contrast CT is more specific, but MRI with diffusion weighted sequences is the best in imaging cholesteatoma, especially residual lesions.  </p><p class="abstract"><strong>Conclusions:</strong> Good correlation was found between HRCT scan and intra-operative findings in cases of cholesteatoma in relation to bony wall erosion of the surrounding structures. CT scan alone cannot differentiate soft tissue masses.</p>

Author(s):  
Gopinathan N. Pillai ◽  
Anjana Mary Reynolds ◽  
Melwin Tom

<p class="abstract"><strong>Background:</strong> 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.  </p><p class="abstract"><strong>Methods:</strong> 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.</p><p class="abstract"><strong>Results:</strong> The study showed a good correlation between pre-operative HRCT of temporal bone and intra operative finding. The findings are statistically significant (p&lt;0.001).</p><p class="abstract"><strong>Conclusions:</strong> The study shows a good correlation between pre-operative HRCT temporal bone and intra-operative findings.</p>


Author(s):  
Akanksha Dhiman ◽  
Ankur Gupta ◽  
Nishi Sharma ◽  
Akhilandeswari Prasad

<p class="abstract"><strong>Background:</strong> 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.</p><p class="abstract"><strong>Methods:</strong> 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.  </p><p class="abstract"><strong>Results:</strong> Upon analysis, in diseased and healthy ears, the coincidence of X-ray and HRCT findings was 63.33% and 80% respectively.</p><p class="abstract"><strong>Conclusions:</strong> 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.  </p>


2015 ◽  
Vol 21 (4) ◽  
pp. 280 ◽  
Author(s):  
Rohan Gupta ◽  
Sonika Kanotra ◽  
Nitika Gupta ◽  
Rashmi Sharma ◽  
Saurabh Gupta ◽  
...  

2019 ◽  
Vol 12 ◽  
pp. 117955061987047 ◽  
Author(s):  
Mariam Aljehani ◽  
Rayan Alhussini

Objectives: The aim of this study was to investigate the correlation between the preoperative findings of high-resolution computed tomography (HRCT) of temporal bone in chronic otitis media (COM) and the intraoperative findings. Methods: This retrospective study was conducted in the ORL-HNS Unit at Ohud Hospital, Medina, Saudi Arabia, during the period from January to September 2018. We included all patients with COM, and an informed consent was obtained from all participants. The HRCT images were studied in comparison with the intraoperative findings. The parameters of comparison were tympanic membrane, middle ear structures, and the status of cholesteatoma. Results: A total of 39 patients were included in the analysis: 14 male and 25 female patients. The age range was 9 to 50 years. As a result of the comparison between HRCT findings and intraoperative observations, we found that incus erosion through computed tomography (CT) was the same as during surgical observation in 12 cases (30.8%). Malleus appeared eroded on CT in 1 case (2.6%); however, 5 cases were seen with that observation during operation (12.8%). Cholesteatoma was similarly seen in the CT scan and during surgery with a significant relation between intraoperative cholesteatoma extending and HRCT findings of the disease (95% confidence level, P-value = 0.001). The sensitivity, specificity, positive predictive value, and negative predictive value were 100% for detecting sigmoid plate erosion, dura exposure, incus erosion, stapes erosion, and malleus-incus joint discontinuity through preoperative CT. Conclusions: Intraoperative findings and HRCT have shown better results with good correlation of diagnostic value regarding the comparisons between recorded observations, especially in detecting sigmoidal plate erosion, dural exposure, incus and stapes erosion, and malleus-incus joint discontinuity. Preoperative CT scan is beneficial and contributory in the decision of indicating surgery to patients.


2019 ◽  
Vol 133 (7) ◽  
pp. 575-579 ◽  
Author(s):  
R Sharma ◽  
R Meher ◽  
J C Passey ◽  
J Kumar ◽  
A Gupta ◽  
...  

AbstractObjectiveTo compare round window niche visibility as seen endoscopically during cochlear implant surgery with pre-operative high-resolution computed tomography of the temporal bone.MethodsNineteen patients scheduled for cochlear implantation, aged 2–20 years, were referred for computed tomography from October 2016 to March 2018. Angles were measured between the lines passing through the mid-sagittal plane and cochlear basal turn on the scans. Endoscopic round window niche visibility during posterior tympanotomy was categorised as: type I = 100 per cent, type IIa = more than 50 per cent, type IIb = less than 50 per cent or type III = 0 per cent. Pre-operative computed tomography measurements were used to predict round window niche visibility before surgery and correlated with intra-operative findings.ResultsThe mean (range) of pre-operative angles on computed tomography for endoscopic visibility types I, IIa and IIb, were 64.06° (61.16–69.37°), 63.81° (58.61–71.35°) and 56.48° (50.37–59.05°), respectively, a statistically significant finding (one-way analysis of variance test, p = 0.016).ConclusionPre-operative high-resolution temporal bone computed tomography measurements are useful in predicting round window niche visualisation as viewed endoscopically during posterior tympanotomy. The angle was more acute in type IIb compared to type I.


1993 ◽  
Vol 29 (5) ◽  
pp. 896
Author(s):  
Tae Beom Kweon ◽  
Hun Seong ◽  
Mal Soon Cheon ◽  
Hack Jin Kim ◽  
Keung Jae Jang ◽  
...  

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