An Evaluation of Preoperative Computed Tomography on Patients with Chronic Otitis Media

Abstract

This study aimed to compare the veracity of computed tomography findings on patients undergoing surgery for chronic otitis media (COM) with the surgical findings, and to determine to what extent the preoperative computerized tomography (CT) findings are useful to the surgeon. A series of 56 patients with COM undergoing preoperative CT scanning followed by surgical exploration of the middle ear and mastoid. Operative notes were recorded and data collected on the nature of soft tissue masses, the status of the ossicles, presence or absence of facial canal dehiscence and semicircular canal (SCC) dehiscence and the presence or absence of dural plate erosion, and sigmoid sinus thrombosis. Fifty-six patients were recruited in the study, 30 males and 26 females. The age range was from 16 to 67 years with a mean of 26.51 ± 1.4 years. The preoperative CT scan imaging in cases of cholesteatoma, ossicular chain erosion and SCC dehiscence have good correlation with the intraoperative findings. The specificity of preoperative CT scan in detecting facial canal dehiscence, dural plate erosion and sigmoid sinus thrombosis in patient of COM were weak.Preoperative computed tomography evaluation is fairly useful especially in cases of cholesteatoma. According to the results of this study, CT is of value particularly in the definition of cholesteatoma, and in determining ossicular chain erosion and semicircular canal fistula.

A study of the correlation between the pre-operative high resolution computed tomography findings and intra-operative findings in chronic otitis media-squamosal type

“…Sensitivity of detecting facial canal erosion was only 60%. These results were comparable to studies by Yildirim et al, Rogha et al and Payal et al [15][16][17]…”

Cautionary High-resolution Computed Tomography Findings for the Presence of Facial Canal Dehiscence in Patients with Cholesteatoma

“…However, there are concerns that HRCT lacks guaranteed sensitivity and specificity for the determination of FCD. In the literature, the sensitivity rates of HRCT for the FCD range from 0 to 100% while the reported specificity rates for FCD are considerably higher [19][20][21][22][23][24][25][26][27]. Tatlipinar et al determined that the thin bone covering the FN was occasionally difficult to evaluate owing to partial volume averaging with adjacent soft tissue; thus, the authors were able to detect 35 of 39 (89.7%) FCD using HRCT with a negative predictive value of 89.7% [17].…”

Comparative Study of Findings of Preoperative Computerised Tomography of Mastoids With Intraoperative Findings in Cases With Csom

“…Evidence of location and extension of disease and of asymptomatic complications secondary to bony erosion influence the management and selection of surgical procedures. (1) Computerised tomography provides reliable details of temporal bone anatomy, congenital malformations, levels of sinus and dural plates and pneumatisation of mastoids. HRCT can show subtle details of cholesteatoma and its extension, involvement of hidden areas, e.g.…”

“…However, there are concerns that CT scan cannot differentiate between cholesteatoma and granulation tissue and it lacks guaranteed sensitivity for erosive complications. (1) Such concerns have raised doubts on its value as routine investigation.…”