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 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 Usefulness of High Resolution Computed Tomography scans in depicting the status of the middle ear structures

2019 ◽  
Vol 6 (2) ◽  
pp. 449
Author(s):  
Ponnam Bharath Kumar ◽  
Kiran Mai ◽  
Santosh Karpur
Keyword(s):  
Computed Tomography ◽  
High Resolution ◽  
Temporal Bone ◽  
Middle Ear ◽  
High Resolution Computed Tomography ◽  
Bony Labyrinth ◽  
The Status ◽  
Hrct Temporal Bone ◽  
Operative Assessment ◽  
Middle Ear Cleft

Background: Prior to surgery it is very important that the surgeon is fully aware, and he should have the clear picture as to the extent of the disease and the nature of the disease to give satisfactory surgical outcomes for the patient. HRCT (High resolution computed tomography) is one such guiding tool for the surgeon. The objective was to study usefulness of HRCT scan in attico-antral disease in depicting the status of the middle ear structures.Methods: A total of 30 patients were studied.  HRCT temporal bone was performed by using SIEMENS EMOTION 16 slice CT machine in axial plane and coronal images were reformatted. Findings of HRCT temporal bone were recorded.  Findings of mastoid exploration surgery were recorded. Report of HRCT of temporal bone was correlated with surgical findings and tabulated using percentages.Results: Surgery showed cholesteatoma in 26 (86.6%) patients. Epitympanum was involved in 29 (96.6%) patients in HRCT and 30 (100%) patients at surgery. Extension beyond middle ear cleft was seen in 4 (13.3%) patients in HRCT and 5 (16.6%) patients at surgery. Tympanic segment of facial canal was the most commonly involved, showing erosion in 10 (33.3%) patients in HRCT and 12 (40%) patients at surgery. Lateral SCC was the most commonly involved in bony labyrinth seen in 4 (13.3%) patients in both HRCT and surgery. Erosion of dural plate was seen in 6 (20%) patients in HRCT whereas 9 (30%) patients showed dural plate erosion at surgery.Conclusions: HRCT of temporal bone plays a promising role in pre-operative assessment of cholesteatoma as it depicts the extent of the disease and integrity of most of the middle ear structures.

scholarly journals Evaluation of Temporal Bone Cholesteatoma and the Correlation between High Resolution Computed Tomography and Surgical Finding

2013 ◽  
Vol 6 ◽  
pp. CMENT.S10681 ◽  
Author(s):  
Mohammed A. Gomaa ◽  
Abdel Rahim A. Abdel Karim ◽  
Hosny S. Abdel Ghany ◽  
Ahmed A. Elhiny ◽  
Ahmed A. Sadek
Keyword(s):  
Computed Tomography ◽  
High Resolution ◽  
Temporal Bone ◽  
Middle Ear ◽  
High Resolution Computed Tomography ◽  
Intravenous Contrast ◽  
Suppurative Otitis Media ◽  
Middle Ear Cholesteatoma ◽  
Intracranial Complications

Background Acquired cholesteatomas are commonly seen in patients less than 30 years. There is a typical history of recurrent middle ear infections with tympanic membrane perforation. The diagnosis of cholesteatoma is usually made on otologic examination. Objective The aim of the work was to study the role of high resolution computed tomography (HRCT) in detecting, evaluating, and diagnosing middle ear cholesteatoma. Patients and methods This was a prospective study that included 56 consecutive patients with chronic suppurative otitis media, unsafe type cholesteatomas. Each patient was subjected to full clinical evaluation, and HRCT examination. Intravenous contrast media was used in some patients with suspected intracranial complication. Preoperative radiological data were correlated with data related to surgical findings. Results The study showed that a high incidence of cholesteatoma in the third decade of life. The scutum and lateral attic wall were the most common bony erosions in the middle ear bony wall (64.3%), and the incus was the most eroded ossicle in the middle ear (88.2%). Sclerosing of mastoid air cells were encountered in 60.7% of patients and the lateral semicircular canal was affected in 9%, while facial canal erosion was found in 21.4%. Temporal bone complications are more common than intracranial complications. HRCT findings were compared with operative features; the comparative study included the accuracy and sensitivity of HRCT in detecting cholesteatoma (92.8%), its location and extension (96.4%), ossicular chain erosion (98%), labyrinthine fistula and intracranial complications (100%). Conclusion The important role of HRCT scannig lies on the early detection of cholesteatoma, and more conservative surgical procedures can be used to eradicate the disease.

Atypical Pharyngitis In Suppurative Otitis Media Cases

2008 ◽  
Vol 139 (2_suppl) ◽  
pp. P98-P99
Author(s):  
Alaa A Abou-Bieh ◽  
Mona F Salama
Keyword(s):  
Middle Ear ◽  
Causative Organism ◽  
Isolation And Identification ◽  
Middle Ear Mucosa ◽  
Suppurative Otitis Media ◽  
Gram Negative ◽  
Middle Ear Infection ◽  
Gram Negative Organisms ◽  
Micro Organisms ◽  
Middle Ear Cleft

Problem Unexplained persistent or recurrent bacterial pharyngitis in some patients who suffer from infected middle ear cleft. Methods Bacteriological swabs were obtained from both the ears and the pharynx of 37 cases with chronic otorrhea and perforation, whom complain of recurrent or persistent sore-throat. Then isolation and identification of the micro-organisms were done. This included examination of direct Gram stained films and cultures. Isolated Gram negative bacilli were subjected to further identification by the biochemical reactions and antibiotyping. Identical isolates from the same patient (ear and pharyngeal swabs) were subjected to further identification by genotyping using the pulsed field gel electrophoresis technique. Results 6 cases (16%) showed identity in phenotypes and genotypes for ear and pharyngeal samples from the same patient. All pharyngeal isolates were Gram negative organisms. 4 of them were Pseudomonas aeruginosa, 1 was Proteus sp., and 1 was Escherichia coli. All of these 3 species are not known to be among the primary organisms which may cause pharyngitis. Conclusion Bacterial pharyngitis in patients with chronically infected middle ear cleft may be attributed to the same organism invaded the middle ear mucosa. Also this study highlights some organisms as a pharyngeal invaders although they are not among the previously documented causatives of bacterial pharyngitis. But the study do not confirm the method of spread of these organisms and whether this was directly via the eustachian tube. Significance The study correlates the causative organism of the middle ear infection and that infected the pharyngeal mucosa utilizing the advanced bacteriological identification and genotyping techniques.

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 COMPUTER AIDED THREE-DIMENSIONAL RECONSTRUCTION AND MODELING OF MIDDLE EAR BIOMECHANICS BY HIGH-RESOLUTION COMPUTED TOMOGRAPHY AND FINITE ELEMENT ANALYSIS

2006 ◽  
Vol 18 (05) ◽  
pp. 214-221 ◽  
Author(s):  
CHIA-FONE LEE ◽  
PEIR-RONG CHEN ◽  
WEN-JENG LEE ◽  
JYH-HORNG CHEN ◽  
TIEN-CHEN LIU
Keyword(s):  
Computed Tomography ◽  
Finite Element Analysis ◽  
Finite Element ◽  
High Resolution ◽  
Temporal Bone ◽  
Middle Ear ◽  
Histological Section ◽  
Slice Thickness ◽  
High Resolution Computed Tomography ◽  
Element Analysis

In order to present a systematic and practical approach that uses high-resolution computed tomography (HRCT) to derive models of the middle ear for finite element analysis (FEA). This prospective study included 31 subjects with normal hearing and no previous otological disorders. Temporal bone images obtained from 15 right ears and 16 left ears were used for evaluation and reconstruction. High-resolution computed tomography of temporal bone was performed using simultaneous acquisition of 16 sections with a collimated slice thickness of 0.625 mm. All images were transferred to an Amira visualization system for 3D reconstruction. The created 3-D model was translated into two commercial modeling packages, Patran and ANSYS, for finite element analysis. The characteristic dimensions of the model were measured and compared with previous published histological section data. This result confirms that the geometric model created by the proposed method is accurate except the tympanic membrane is thicker than that of histological section method. No obvious difference in the geometrical dimension between right and left ossicles was found (p > 0.05). The 3D model created by finite element method and predicted umbo and stapes displacements are close to the bounds of the experimental curves of Nishihara's, Huber's, and Gan's data across the frequency range of 100-8000 Hz. The model includes a description of the geometry of the middle ear components, and dynamic equations of vibration. The proposed method is quick, practical, low cost and most importantly, non-invasive as compared with histological section methods.

scholarly journals Functional and anatomical results of inside out approach for cholesteatoma surgery

2018 ◽  
Vol 4 (2) ◽  
pp. 481 ◽  
Author(s):  
Priyanka Chamoli ◽  
Chandra Veer Singh ◽  
Sheetal Radia ◽  
Anand K. Shah
Keyword(s):  
Quality Of Life ◽  
Middle Ear ◽  
Residual Disease ◽  
Suppurative Otitis Media ◽  
Initial Improvement ◽  
Canal Wall Down ◽  
The Mean ◽  
Inside Out ◽  
Middle Ear Cleft

<p class="abstract"><strong>Background:</strong> The objective of the study was t<span lang="EN-IN">o study the efficacy of inside-out approach in completely eradicating the cholesteatoma from middle ear and mastoid, preservation of hearing and quality of life post mastoidectomy with regards to recurrent discharge, wax, granulations. </span></p><p class="abstract"><strong>Methods:</strong> <span lang="EN-IN">Non-randomizedprospective observational study performed at the Department of ENT in Bombay hospital Mumbai. The study involved 40 patients presenting with chronic suppurative otitis media with cholesteatoma. All of them underwent inside out mastoidectomy and were followed up till the end of the study to evaluate the efficacy of inside out mastoidectomy in eradicating the disease from the middle ear cleft, to assess preservation of hearing and to assess cavity problems.  </span></p><p class="abstract"><strong>Results:</strong> <span lang="EN-IN">Of the 40 patients, 39 patients had a total clearance of disease by the inside out approach, and in 1 patient, we were doubtful of the clearance. All patients came for regular follow up and none of them had residual disease at the end of the study period. Thus, the overall success rate was 100% in this study. A significant improvement in the mean air conduction (p&lt;0.01) and the mean air bone gap (p&lt;0.01) postoperatively was seen in all in the postoperative 3<sup>rd</sup> month PTA. Only one patient had increased conductive hearing loss one and a half years postoperatively after initial improvement. A dry self-cleansing cavity was achieved in 95% of the patients and only 5% required regular cleaning of waxes the cavities. </span></p><p class="abstract"><strong>Conclusions:</strong> <span lang="EN-IN">Inside out mastoidectomy is a better alternative in canal wall down procedures as it not only clears the disease from the middle ear cleft, but also leaves behind a small postoperative cavity, which will preserve the hearing, decrease the cavity problems and increase the quality of life of such patients.</span></p>

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