BackgroundPre-operative assessment of middle ear cholesteatoma is a must for assessing the disease's location, extent, and complication, and high-resolution computed tomography (HRCT) is the modality of choice. Therefore, this study aims to assess the common signs of cholesteatoma on HRCT and its diagnostic ability.
MethodsFifty patients with suspected cholesteatoma were considered for the study, which was carried out on an Ingenuity Core 128 slice CT scanner (Philips, Amsterdam, Netherlands). The bilateral temporal bones of 50 patients were assessed for soft tissue density and associated findings. The number of temporal bones with soft tissue density was then correlated with intra-operative and histopathological examinations (HPE).
ResultsOut of 100 temporal bones, 63 were diseased, and 37 were normal temporal bones. Epitympanum/Prussak's space was the most involved site with soft tissue density seen in 60/63 (95.2%) diseased temporal bones, followed by aditus ad antrum and mesotympanum, which was seen in 51/63 (80.9%) diseased temporal bones. The majority of the soft tissue lesions were non-dependent, accounting for 43/63 (68.2%) of the diseased temporal bones. Bony erosions were seen in 54/63 (85.7%) and bony expansion in 35/63 (55.5%) of the diseased temporal bones. HRCT showed a sensitivity of 100%, specificity of 88.1%, a positive predictive value (PPV) of 92.1%, a negative predictive value (NPV) of 100%, and accuracy of 95% for detection of cholesteatoma.
ConclusionHRCT of the temporal bone precisely demonstrates cholesteatoma's location, extent, and bony changes. Therefore, it has exceptional sensitivity, high specificity, and accuracy in diagnosing cholesteatoma.
<p><strong>Background:</strong> Deep neck space infections are usually due to excessive growth of normal flora, mostly of polymicrobial in origin. Patients present acutely with complaints of, throat and neck pain, raised body temperature. The clinical presentation depends on the deep neck space affected.<strong></strong></p><p><strong>Methods:</strong> Current study was carried out in 25 patients who were diagnosed to have various deep neck infections</p><p><strong>Results:</strong> It was observed that the maximum number of cases were seen in the age group of 31-40 at 28%, followed by 21-30 age group at 20%, 16% each between 41-50 years and above 60 years. The male to female ratio is 1:0.78. The most common presenting complaints included fever (24 patients; 96%) and dysphagia (18 patients; 72%). 13 patients (52%) had associated systemic disease, 5 patients (20%) had history of diabetes mellitus and were on irregular treatment, 4 patients (16%) was on treatment for hypertensive. The most common infection was Ludwig’s angina seen in 13 patients (52%), followed by peritonsillar abscess 4 patients (16%). Out of 25 patients, 20 (80%) cases were treated successfully by incision and drainage. No growth was observed in 32% of the patients.</p><p><strong>Conclusions:</strong> Early diagnosis of deep neck space infection based on symptoms in susceptible patients is advisable to prevent complications and early recovery.</p>
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