scholarly journals Computed-Tomography-Structured Reporting in Middle Ear Opacification: Surgical Results and Clinical Considerations From a Large Retrospective Analysis

2021 ◽  
Vol 12 ◽  
Author(s):  
Michele Cavaliere ◽  
Antonella Miriam Di Lullo ◽  
Camilla Russo ◽  
Massimo Mesolella ◽  
Elena Cantone ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Ct Scan ◽  
Temporal Bone ◽  
Eustachian Tube ◽  
Middle Ear ◽  
Surgical Planning ◽  
Chronic Otitis Media ◽  
Anatomical Site ◽  
Vascular Structures ◽  
Bony Erosion

Purpose: The aim of the study is to compare the accuracy of unstructured preoperative Computed Tomography (CT) reports from non-tertiary diagnostic centers with intraoperative findings in a large cohort of patients with Chronic Otitis Media (COM) undergone surgery.Methods: From 2012 to 2019, a total number of 301 patients were considered for our purposes. All patients with clinical evidence of COM had preoperative non-contrast high resolution CT scan of the temporal bone in non-tertiary diagnostic centers, performed within 3 months before surgery.Results: The accuracy of CT reports was analyzed in terms of nature, anatomical site, disease extension, bony erosion, vascular structures abnormalities relevant to surgical planning, and Eustachian tube patency. Compared to post-surgical findings, CT reporting critical analysis revealed a tendency to overestimation of bony erosion, coupled to underestimated description of facial canal/lateral semi-circular canal, vascular structures, and Eustachian tube.Conclusion: Discrepancies between CT reports and surgical findings in middle ear opacification can be at least in part due to limited expertise of general radiologists in ENT neuroimaging. To limit this lack of information and the limited accuracy of middle ear structures depiction, here we propose a structured checklist to adopt in the case of a temporal bone CT scan for COM, in order to optimize the communication with surgeons and provide all the crucial information for an accurate surgical planning.

Diagnostic imaging in chronic otitis media: does CT and MRI fusion aid therapeutic decision making? – a pilot study

2018 ◽  
Vol 72 (5) ◽  
pp. 1-5 ◽  
Author(s):  
Artur Kusak ◽  
Oskar Rosiak ◽  
Marcin Durko ◽  
Piotr Grzelak ◽  
Wioletta Pietruszewska
Keyword(s):  
Computed Tomography ◽  
Magnetic Resonance ◽  
Temporal Bone ◽  
Middle Ear ◽  
Chronic Otitis Media ◽  
Histopathological Diagnosis ◽  
Anatomical Landmarks ◽  
Surgical Interventions ◽  
Histopathological Evaluation ◽  
Ct And Mri

Introduction: Despite the recent advances in otosurgery diagnosis of cholesteatoma and qualification for surgery remains an issue in contemporary laryngology. In cases of cholesteatoma recidivism, it is of utmost importance to properly locate the pathology in the middle ear to plan surgical approach. Magnetic Resonance imaging in diffusion weighted non-echoplanar sequences (non-EPI DWI) enables cholesteatoma detection as small as 2 mm and could potentially prevent unnecessary second-look surgery. Computed Tomography of the temporal bone allows precise visualization of bony structures and topographical landmarks of the middle ear. A fusion of both imaging modalities combines the advantages of these techniques. Material and methods: Five patients treated in the Department of Otolaryngology, Medical University of Lodz for probable cholesteatoma recidivism were included in this study. A high-resolution CT scan of the temporal bone and an MRI scan including non-EPI sequences was obtained in all patients. A fusion of CT and MRI studies was conducted using OsirixMD software. Fist, CT studies were fused with MRI BFFE sequences, then non-EPI sequences were added. Finally, if the patient qualified for surgical treatment histopathological diagnosis was compared with MRI results. Results: CT scans were analyzed to establish the extent of previous surgical interventions and anatomical landmarks preservation. In all cases MRI results were suspicious of cholesteatoma recidivism. Four cases were confirmed in postoperative histopathological evaluation, there was one false positive case when intraoperatively scar tissue was identified, which was later confirmed as connective tissue upon histopathological evaluation. Conclusions: CT and MRI fusion provides a helpful diagnostic tool in preparation for surgery in patients with suspected cholesteatoma recidivism. Key words: magnetic resonance, computed tomography, cholesteatoma, canal wall-up surgery

scholarly journals High resolution computed tomography of temporal bone in the evaluation of otologic diseases

2017 ◽  
Vol 4 (1) ◽  
pp. 87
Author(s):  
Prakash S. Handi ◽  
Mallikarjun N. Patil ◽  
Nisha P.
Keyword(s):  
Computed Tomography ◽  
High Resolution ◽  
Ct Scan ◽  
Temporal Bone ◽  
Middle Ear ◽  
Tertiary Care ◽  
Age Groups ◽  
Tertiary Care Centre ◽  
High Resolution Computed Tomography ◽  
Bone Anomalies

<p class="abstract"><strong>Background:</strong> <span lang="EN-IN">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. </span></p><p class="abstract"><strong>Methods:</strong> <span lang="EN-IN">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 (%).  </span></p><p class="abstract"><strong>Results:</strong> <span lang="EN-IN">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. </span></p><p class="abstract"><strong>Conclusions:</strong> <span lang="EN-IN">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.</span></p>

scholarly journals A STUDY OF RADIOLOGICAL CHANGES IN CSOM AND THEIR CO-RELATION WITH INTRA-OPERATIVE SURGICAL FINDING

2020 ◽  
Vol 4 (12) ◽  
Author(s):  
Vishal Hansrajani ◽  
Navin Agrawal ◽  
Chhavi Agrawal ◽  
Kriti Shrivastav ◽  
Parul Parmar ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Ct Scan ◽  
Temporal Bone ◽  
Middle Ear ◽  
Chronic Otitis Media ◽  
Tissue Changes ◽  
Radiological Changes ◽  
Soft Tissue Changes ◽  
Hrct Temporal Bone ◽  
Middle Ear Cleft

Introduction: HRCT temporal bone is the currently widely used investigation for the chronic otitis media patient especially in unsafe disease. Aim: This study was conducted to assess the condition of the middle ear in CSOM by HRCT temporal bone and compare them with intraoperative finding of the middle ear cleft . Method: Study group includes patients of Attico-antral variety of CSOM presenting in ENT OPD in our institution over a period of 18 months who undergone Computed Tomography Temporal bone followed by Surgical Procedure. Results: After study it was observed that CT scan can reliably detect bony & soft tissue changes in middle ear and intracranial complication. It can detect soft tissue in the middle ear but can not differentiate between soft tissue and cholesteatoma.  Conclusion: CT scan provides excellent anatomical details and pathological changes of the ear and mastoid. Scanning all the patients is not feasible and justified, so we need to select patients in whom diagnosis and extend of the diseases is in doubt.  

A comparison of high resolution CT scan of temporal bone and operative findings in middle ear cholesteatoma

1993 ◽  
Vol 29 (5) ◽  
pp. 896
Author(s):  
Tae Beom Kweon ◽  
Hun Seong ◽  
Mal Soon Cheon ◽  
Hack Jin Kim ◽  
Keung Jae Jang ◽  
...  
Keyword(s):  
High Resolution ◽  
Ct Scan ◽  
Temporal Bone ◽  
Middle Ear ◽  
High Resolution Ct ◽  
Middle Ear Cholesteatoma ◽  
Operative Findings

Comparison of the Aditus ad Antrum Diameter on CT between Patients with Chronic Otitis Media and Healthy Individuals

2019 ◽  
Vol 15 (10) ◽  
pp. 990-993 ◽  
Author(s):  
Elif Gündoğdu ◽  
Uğur Toprak
Keyword(s):  
Computed Tomography ◽  
Otitis Media ◽  
Middle Ear ◽  
Healthy Subjects ◽  
Normal Values ◽  
Chronic Otitis Media ◽  
Healthy Individuals ◽  
Inner Diameter ◽  
Male Patients ◽  
The Right

Background: The middle ear cavity is ventilated through the aditus ad antrum. Aditus blockage contributes to the pathology of otitis media. Objective: To determine the normal values of the aditus ad antrum diameter on computed tomography and to investigate its relationship with chronic otitis media and related pathologies (tympanosclerosis and myringosclerosis). Methods: The temporal CT images of 162 individuals were evaluated retrospectively. In the axial sections, the inner diameter of the aditus was measured at the narrowest point at the cortex. The differences in diameter were compared between diseased and healthy ears. Results: In healthy individuals, the diameter was narrower in women. There was no difference between the right and left ears in healthy subjects. No correlation was found between age and diameter. In male patients with myringosclerosis, the diameter was slightly narrower on both sides but more marked on the left. In female patients with myringosclerosis, the diameter in both ears was slightly narrower. In cases of otitis media and tympanosclerosis, the diameter was less than that of healthy individuals, despite the lack of statistically significant result in all cases. Conclusion: The aditus ad antrum was narrower in diseased ears, indicating that a blocked aditus may contribute to the development of otitis media, as well as mucosal diseases.

scholarly journals Comparative study between throat swab and ear discharge swabs culture and sensitivity findings in pediatric patients with bilateral chronic otitis media

2019 ◽  
Vol 5 (4) ◽  
pp. 932
Author(s):  
Sudhakar Rao M. S. ◽  
Navneeth T. P.
Keyword(s):  
Otitis Media ◽  
Eustachian Tube ◽  
Middle Ear ◽  
Throat Swab ◽  
Chronic Otitis Media ◽  
Age Group ◽  
Pediatric Age ◽  
Pediatric Age Group ◽  
The Common ◽  
Culture And Sensitivity

<p class="abstract"><strong>Background:</strong> Chronic otitis media is one of the common infections seen in pediatric age group. The most widely recognized route of infection is via the eustachian tube. The inflammation of the pharyngeal end of the eustachian tube may prevent gas exchange, leading to lowering of the middle ear pressure and predisposes to aspiration of nasopharyngeal microbes into the middle ear cleft.</p><p class="abstract"><strong>Methods:</strong> Eighty (80) cases of clinically diagnosed chronic otitis media among pediatric age group of both sexes selected on simple random basis were included in this study. Swabs from both ears and throat were taken and the samples were sent under strict aseptic conditions for culture and sensitivity testing.  </p><p class="abstract"><strong>Results:</strong> The mean age of patients was 6.1years and the frequency of chronic otitis media was maximum in 1-5 years age group. Male to female ratio was 1.6:1.The most frequent organism isolated was <em>S. Aureus</em> followed by <em>Psuedomonas</em>. The ear swab and throat swab findings showed positive relationship (p&lt;0.05) for the common organisms i.e., <em>S. Aureus</em>, <em>pseudomonas</em> and <em>Streptococcus pyogenes</em> respectively, thus suggesting a common etiological agent. Psuedomonal infection was found to be associated with large perforation in tympanic membrane.</p><p class="abstract"><strong>Conclusions:</strong> The pathology in bilateral ear disease is central i.e., throat. Treatment in these cases is focused on selected drug with optimum dose and calculated regimen of treatment completely, thus reducing the morbidity of loss of physiological function of the ear and the grave complications involved.</p><p> </p>

Sign in / Sign up

Export Citation Format

Share Document