scholarly journals Akurasi Gambaran CT Scan Tulang Temporal Preoperatif dalam Menilai Kolesteatoma pada Penderita Otitis Media Supuratif Kronis (OMSK)

e-CliniC ◽  
2021 ◽  
Vol 9 (2) ◽  
pp. 351
Author(s):  
A. Fitrah Muhibbah ◽  
Mirna Muis ◽  
Nurlaily Idris ◽  
Andi A. Zainuddin ◽  
Masyita Gaffar ◽  
...  
Keyword(s):  
Ct Scan ◽  
Temporal Bone ◽  
Otitis Media ◽  
Predictive Value ◽  
Bone Erosion ◽  
University Hospital ◽  
Chronic Suppurative Otitis Media ◽  
Suppurative Otitis Media ◽  
Temporal Bone Ct ◽  
Preoperative Ct

Abstract: This study was aimed to determine the accuracy of preoperative temporal bone CT-scan ini assessing cholesteatoma in chronic suppurative otitis media (CSOM) patients. This was a diagnostic test study conducted by comparing the findings of the preoperative temporal bone CT-scan with the intraoperative findings of 54 CSOM patients who had a temporal bone CT-scan followed by surgery at the Hasanuddin University Hospital and the Jaury Academic Hospital. Assessment of cholesteatoma on a preoperative temporal bone CT-scan was performed when soft tissue density was found in the middle ear accompanied by bone erosion. In addition, an assessment was also carried out for the presence of ossicular, scutum, tympanic tegmen, facial nerve canal and mastoid tegmen erosions. The results indicated that the accuracy of preoperative temporal bone CT-scan in assessing cholesteatoma in CSOM patients was 87.04% with a sensitivity of 85%, specificity of 88.23%, a positive predictive value of 80.95%, and a negative predictive value of 90.91%. The sensitivity of the preoperative temporal bone CT-scan in assessing the highest erosion of cholesteatoma in the erosion of the scutum and tympanic tegmen (100%) with the specificity and accuracy of the preoperative temporal bone CT scan of the in assessing erosions in cholesteatoma highest on mastoid tegman erosion  (100% and 96.29%). In conclusion, preoperative CT scan of temporal bone has high accuracy, sensitivity, and specifity values in assessing cholesteatoma and erosions of surrounding structures.Keywords: cholesteatoma, chronic suppurative otitis media (CSOM), temporal bone CT-Scan  Abstrak: Penelitian ini bertujuan untuk mengetahui akurasi gambaran CT-scan tulang temporal preoperatif dalam menilai kolesteatoma pada penderita otitis media supuratif kronis (OMSK). Jenis penelitian ialah uji diagnostik yang membandingkan temuan pada CT scan tulang temporal preoperatif dengan hasil temuan intraoperatif pada 54 penderita OMSK yang menjalani pemeriksaan CT scan tulang temporal dilanjutkan dengan tindakan operasi di Rumah Sakit Universitas Hasanuddin dan Rumah Sakit Akademis Jaury. Penilaian kolesteatoma pada CT Scan tulang temporal preoperatif ketika ditemukan densitas jaringan lunak di telinga tengah yang disertai dengan erosi tulang. Selain itu, dilakukan penilaian adanya erosi osikula, skutum, tegmen timpani, kanalis nervus fasialis, dan tegmen mastoid. Hasil penelitian mendapatkan akurasi CT scan tulang temporal preoperatif dalam menilai kolesteatoma pada penderita OMSK sebesar 87,04% dengan sensitivitas 85%, spesifisitas 88,23%, nilai prediksi positif 80,95%, dan nilai prediksi negatif 90,91%. Sensitivitas CT scan tulang temporal preoperatif dalam menilai erosi pada kolesteatoma tertinggi pada erosi skutum dan tegmen timpani (100%) dengan spesifisitas dan akurasi CT scan tulang temporal preoperatif dalam menilai erosi pada kolesteatoma tertinggi pada erosi tegmen mastoid (100% dan 96.29%). Simpulan penelitian ini ialah CT scan tulang temporal preoperatif memiliki nilai akurasi, sensitivitas, serta spesifisitas yang cukup tinggi dalam menilai kolesteatoma serta erosi pada struktur di sekitarnya.Kata kunci: kolesteatoma, otitis media supuratif kronis (OMSK), CT scan tulang temporal

scholarly journals Comparison of Temporal Bone Tomography Findings of Chronic Otitis Media with Intraoperative Findings

2019 ◽  
Vol 7 (2) ◽  
pp. 17
Author(s):  
Yalda Jabbari Moghaddam ◽  
Farnaz Chalabianloo
Keyword(s):  
Ct Scan ◽  
Temporal Bone ◽  
Otitis Media ◽  
Chronic Otitis Media ◽  
Common Disease ◽  
Suppurative Otitis Media ◽  
X Ray ◽  
Temporal Bone Ct ◽  
Preoperative Ct ◽  
Surgical Field

Background and Objectives: Chronic otitis media is considered a common disease in our region. There are various methods for evaluation of chronic suppurative otitis media including otoscopy, CT scan, X-ray, and MRI. Nowadays, computed tomography or CT scan is used as the selected method to investigate the temporal bone. This study aims to collect the intraoperative findings and compare them with preoperative reports of temporal bone CT scans. Materials and Methods: The patients’ data with chronic otitis media who were reviewed tomographically, hospitalized and operated between 2012 and 2014 in Tabriz Sina Hospital by only one otolarynologist included in this study collected. Results: The most common lesion based on the highest frequency and percentage is Tympanosclerosis. 21.4 percent of patients whom Tympanosclerosis were not diagnosed preoperatively, found during the surgery. 78.9 And 21.1 percent of bone erosions have been diagnosed by CT scan and by direct vision, respectively. Conclusion: Although preoperative CT of Middle ear lesions is useful for surgery planning but some lesion may not be completely diagnosed by CT scan and intraoperative assessment of surgical field is crucial.

scholarly journals Association of the Laterality of Chronic Suppurative Otitis Media with the Laterality of Sinonasal Disease Based on Temporal Bone CT - Scan Results and Lund Mackay Scoring System

2016 ◽  
Vol 31 (2) ◽  
pp. 16-19
Author(s):  
Walfrido C. Adan ◽  
Emmanuel Tadeus S. Cruz
Keyword(s):  
Ct Scan ◽  
Temporal Bone ◽  
Otitis Media ◽  
Scoring System ◽  
Numerical Data ◽  
Chronic Suppurative Otitis Media ◽  
Suppurative Otitis Media ◽  
Temporal Bone Ct ◽  
Significant Difference ◽  
Sinonasal Disease

Objective: To determine the association between the laterality of chronic suppurative otitis media (CSOM) and the laterality of sinonasal disease, based on temporal bone ct-scan results and Lund-Mackay Scoring system, among patients admitted for ear surgery in a tertiary government hospital in Metro Manila. Method: Design:            Retrospective review of records Setting:           Tertiary Government Hospital Patients:         Ninety-eight patients diagnosed with chronic suppurative otitis media admitted for otologic surgery in the Department of Otorhinolaryngology – Head and Neck Surgery from January 2011 to June 2014 were considered for inclusion. Hospital charts and temporal bone ct-scan results were retrieved and analyzed for ear and sinonasal radiographic abnormalities and laterality. Excluded were those without CT-scan plates, who underwent temporal bone surgery for reasons other than chronic suppurative otitis media, and those with incomplete records. The Lund-Mackay Scoring System was used to grade sinonasal findings which were compared to CSOM complications. Data was analyzed using t-test, ANOVA for homogenous numerical data, Kruskal-Wallis for heterogenous numerical data, and chi-square test for nominal type of data.   Results: Of the 64 patients included in the study, 12 or 18.75% had radiographic sinonasal abnormalities.  There was no significant association between the laterality of ear disease and the laterality of sinonasal pathology as there was no significant difference in the proportion of subjects with sinonasal disease according to laterality of CSOM (p=.32). When site of nose pathology was compared to Lund-Mackay graded scores, it was found that bilateral nose pathology generally had a higher Lund-Mackay score of 8.60 ± 5.60. However, there was no significant difference in the Lund-Mackay score according to the nose pathology site (p=.20).   An association was seen between total LMS and patients with ear pathologies, but no significant difference was noted (p=.44).  Although patients with ear complications had higher LM scores, this was not statistically significant. Conclusion: Laterality of ear disease was not associated with the laterality of sinonasal disease, although CSOM complications were associated with high Lund-Mackay scores. Future, better-designed studies may shed more light on these associations. Keywords: chronic suppurative otitis media, sinonasal disease, Lund-Mackay, Temporal Bone CT-Scan            

scholarly journals Local and systemic oxidative stress in chronic suppurative otitis media

2021 ◽  
pp. 148-156
Author(s):  
I. D. Dubinets ◽  
M. Yu. Korkmazov ◽  
A. I. Sinitskii ◽  
E. I. Danshova ◽  
I. N. Skirpichnikov ◽  
...  
Keyword(s):  
Oxidative Stress ◽  
Lipid Peroxidation ◽  
Surgical Treatment ◽  
Temporal Bone ◽  
Otitis Media ◽  
Local Level ◽  
Chronic Suppurative Otitis Media ◽  
Suppurative Otitis Media ◽  
Lipid Peroxidation Products ◽  
Systemic Level

Introduction. According to the literature, oxidative stress is described as one of the main factors in the pathogenesis of chronic suppurative otitis media, supporting the inflammatory process at the local level. The transition of inflammatory mediators to the systemic level is associated with the risk of developing ear purulent-destructive complications. The study of the products of lipid peroxidation in comparison with morphological changes in the structures of the temporal bone will justify the tactics of the operation.Aim. Comparison of the levels of lipid peroxidation products at the local and systemic levels in chronic suppurative otitis media, depending on the nature of pathomorphological changes in the structures of the temporal bone.Materials and methods. A prospective study of 130 patients with chronic suppurative otitis media at the age of 20-62 years with a verified diagnosis of chronic suppurative otitis media, admitted for surgical treatment, was carried out. To study the indicators of oxidative stress at the systemic level, the blood serum of patients was used; at the local level, the bone biomaterial obtained from patients during the surgical treatment of chronic suppurative otitis media was used. The quantitative determination of the primary, secondary and final products of peroxidation was carried out in the groups of patients with separate registration of lipoperoxides in the heptane and isopropanol phases of the lipid extract by spectrophotometry.Results and discussion. In the observation of patients with morphological signs of purulent destruction of the temporal bone, not only a local level of inflammation activity, but also a systemic level of an unfavorable outcome was revealed in two variants: osteoproliferation or osteonecrosis of the bone tissue of the temporal bone in chronic purulent otitis media with a constant threat to the patient's life due to intracranial purulent complications.Conclusion. The appearance in low concentrations of lipid peroxidation products in serum in patients with chronic purulent otitis media substantiates the need for a behind-the-ear approach in reconstructive-sanitizing otosurgery even with minimal clinical manifestations and CT scan data, since at the preclinical level it confirms the osteonecrotic type of bone remodeling with the risk of delayed death.

Frequency of Incus Bone Erosion on Mastoid Exploration in Chronic Suppurative Otitis Media with Middle Ear Cholesteotoma

2021 ◽  
Vol 15 (6) ◽  
pp. 1426-1428
Author(s):  
W. Javaid ◽  
A. Rashid ◽  
M. U. K. Amin ◽  
T. Khan ◽  
M. Fatima
Keyword(s):  
Otitis Media ◽  
Middle Ear ◽  
Bone Erosion ◽  
Age Groups ◽  
Chronic Suppurative Otitis Media ◽  
Cross Sectional ◽  
Suppurative Otitis Media ◽  
Middle Ear Cholesteatoma ◽  
Sample Technique ◽  
Operative Findings

Background: Cholesteotoma is a benign but destructive lesion leading to ossicular necrosis. Objective: To see the frequency of incus bone erosion on mastoid exploration in chronic suppurative otitis media with middle ear cholesteotoma. Study Design: Cross-sectional descriptive study. Setting: This study was carried out in the Department of ENT Unit-2, Sir Ganga Ram Hospital, Lahore. Duration of Study: Fifteen months months (10th April, 2019 to 9th July, 2020) Sample technique: Non- probability purposive sampling Methods: One hundred and twenty patients were admitted through outpatient department of ENT Unit-2, Sir Ganga Ram Hospital Lahore. Patients were included after fulfilling the inclusion criteria and information was collected on a prescribed proforma. Finally during surgery under general anesthesia, the operative findings were noted to know the incus bone erosion after middle ear cholesteatoma formation in chronic suppurative otitis media. Results: A total number of one hundred and twenty patients of chronic suppurative otitis media with middle ear cholesteatoma were included. Out of which 80 (66.7%) were males and 40 (33.3%) were females(Table 1).The patients shown in table 2 were divided in six age groups (Table 2).Table 3 shows that the procedure of mastoidectomy was performed in 112 patients (93.3%) and modified radial mastoidectomy was performed in 8 patients (6.7%).Incus bone erosion in chronic suppurative otitis media with middle ear cholesteatoma in 102 patients (85%) and 18 patients (15%) have no incus bone erosion (Table 4). Conclusion: Ear discharge was the most common presenting characteristic of chronic suppurative otitis media with cholesteatoma. The majority of the cases had ossicular erosion, with the incus being the most common site of involvement. Males are more likely than females to develop cholesteatoma. Keywords: erosion of incus bone, Mastoid exploration, Chronic suppurative otitis media, Cholesteatoma

scholarly journals Double Trouble of Double Fistulae

Biomedicine ◽  
2021 ◽  
Vol 41 (1) ◽  
pp. 163-165
Author(s):  
Deviprasad Dosemane ◽  
Meera Niranjan Khadilkar ◽  
Shreyanshi Gupta ◽  
Pooja Nambiar ◽  
Ria Mukherjee
Keyword(s):  
Otitis Media ◽  
Semicircular Canal ◽  
Bone Erosion ◽  
Chronic Suppurative Otitis Media ◽  
Radical Mastoidectomy ◽  
Lateral Semicircular Canal ◽  
Suppurative Otitis Media ◽  
Labyrinthine Fistula ◽  
Modified Radical Mastoidectomy

The complications of attico-antral type of Chronic Suppurative Otitis Media (CSOM) are severe due to underlying bone erosion. We describe a case of a 40-year-old lady with attico-antral CSOM and mastoiditis with a postauricular fistula, who underwent modified radical mastoidectomy with excision of the postauricular cutaneous mastoid fistula. Interestingly, another fistula over the dome of lateral semicircular canal was noted intraoperatively.Few reports of occurrence of postauricular mastoid fistula with a labyrinthine fistula have been documented.

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>

The value of CT scanning in chronic suppurative otitis media

1991 ◽  
Vol 105 (12) ◽  
pp. 990-994 ◽  
Author(s):  
B. J. O'Reilly ◽  
E. B. Chevretton ◽  
I. Wylie ◽  
C. Thakkar ◽  
P. Butler ◽  
...  
Keyword(s):  
Otitis Media ◽  
Bone Erosion ◽  
Ct Scanning ◽  
Ossicular Chain ◽  
Chronic Suppurative Otitis Media ◽  
Facial Canal ◽  
High Definition ◽  
Suppurative Otitis Media ◽  
Small Areas ◽  
Lateral Canal

AbstractHigh definition CT has been advocated for the evaluation of chronic suppurative otitis media (CSOM) either generally or in selected cases. It is said to be capable of producing the fine detail needed to detect lateral canal fistulae, exposed dura and facial canal dehiscences, and to demonstrate the ossicular chain. At present there is no agreement on either the indications for CT scanning in CSOM or the most appropriate scanning plane. To determine the value of high definition CT in CSOM and to decide a unit policy for its application, 36 cases of CSOM underwent pre-operative CT scanning and their scans were compared with the operative findings.Our results show CT to be highly sensitive to the presence of soft tissue disease and bone erosion, moderately sensitive to the presence of lateral canal fistulae but less sensitive to the presence of small areas of exposed dura, ossicular continuity and facial canal dehiscence. Axial scans were better able to demonstrate the lateral canal but otherwise coronal scans were superior; ideally patients should be scanned in both planes. The principle value of CT in CSOM is its ability to demonstrate disease which is not clinically apparent.

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