Comparison of Ossicular Chain Status by Pre-Operative Cone Beam Computed Tomography (CBCT) with Intra-Operative Findings in Patients with Conductive Hearing Loss

Abstract

Introduction: Maxillofacial radiology usually confines to the gnathic region and is restricted to the jurisdiction of stomatologists. Recently, the ability of CBCT in maxillofacial imaging other than the dentoalveolar structures has been elucidated, thereby expanding the purview to other areas of medical fraternity especially in the field of Otolaryngology. In contrast to the conventional CT, CBCT is an affordable imaging modality with high area specific resolution and low radiation dose, the properties which could be utilized for imaging of the ear ossicles Aim: To compare the ossicular chain status from pre-operative CBCT with intra-operative findings in patients with Conductive Hearing Loss (CHL). Patients and Methods: Between December 2015 and November 2017, a comparative study was conducted among thirty patients diagnosed with Conductive Hearing Loss (CHL). Preoperative Bilateral Ear CBCT scans were acquired using Kodak CS 9300 3D unit. The ossicular chain status from the CBCT scans was interpreted by two radiologists independently and the surgical findings were recorded by an otorhinolaryngologist. Statistical analysis used:The radio-surgical findings were tabulated and compared using Cohen's Kappa coefficient test. Results:The agreement between the observers was categorized into poor, moderate, good and excellent. A moderate to good radio-surgical agreement was obtained in the assessment of erosion of all the three ossicles and the ossicular joints. Relation between patient's results and types of graft used showed no statistically significant differences between them. Conclusion:Considering the advantages, CBCT can be considered as an exceptional substitute for CT in the diagnosis and postoperative follow-up examination of ear pathologies when evaluating bony components, especially in children.