CT scanning of middle ear cholesteatoma: what does the surgeon want to know?

Yates, P.; Flood, L M; Banerjee, Anirban; Clifford, Kevin

doi:10.1259/bjr.75.898.750847

Cited by 50 publications

(45 citation statements)

References 8 publications

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“…In early stage with limited disease to diagnose cholesteatoma on scan is difficult. 7 Visualization of the bodies of the malleus and the incus on HRCT is relatively easier however it is of little clinical value unless the whole ossicular chain can be demonstrated (8) . Mafee et al 9 .…”

Section: Resultsmentioning

confidence: 99%

Incidence of CSOM Unsafe Type in Rural Population of Central India

Agrawal¹

2017

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Section: Resultsmentioning

confidence: 99%

Incidence of CSOM Unsafe Type in Rural Population of Central India

Agrawal¹

2017

jmscr

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“…However, the cost and exposure to radiation are limitations for routine use. Most otologists reserve scans for selected cases, such as patients with complications related to COM, those with suspected congenital abnormalities, loss of landmarks due to previous surgery, and an inability to visualize the tympanic membrane [2,3].…”

Section: Discussionmentioning

confidence: 99%

The role of computed tomography scanning in chronic otitis media

Tatlipinar

Tuncel

Ogredik

et al. 2011

Eur Arch Otorhinolaryngol

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The purpose of this study was to determine the role of high-definition computed tomography (CT) in chronic otitis media (COM) patients and to present which parameters were useful or misleading for preoperative evaluation for management. Fifty cases of COM that underwent preoperative CT scanning at a tertiary referral center were retrospectively analyzed. Their CT scan reports were compared with the operative findings. The patients had undergone tympanoplasty with or without mastoidectomy for COM between April 2008 and January 2010. Patient charts were used to obtain the necessary data. In 62% (31/50) of cases, the CT scan showed the presence of cholesteatoma. Operative findings revealed cholesteatoma in 61.8% (19/31) of these cases. However, when a bone eroding soft tissue mass involved the epitympanum on CT, the presence of cholesteatoma was observed in 83.3% (15/18) of cases intraoperatively. Cholesteatoma was present in the mastoid or middle ear intraoperatively in 77.7% (7/9) of patients with an external ear bony canal defect found on CT. Despite 89.7, 85.29, and 90% agreement ratios for dehiscence of facial canal, lateral semicircular canal, and tegmen, respectively, CT could not detect dehiscence of these anatomic structures successfully. Based on these results, CT scanning has limitations but is a useful adjunct for the surgical management of COM patients.

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“…Of greater predictive value in the diagnosis of cholesteatoma was the presence of abnormal soft tissue densities with bony erosion. 12 In summary, the use CT in the case of chronic suppurative otitis media and before the determination of any complications does provide valuable information. HRCT scanning is a unique method of detection of early cholesteatoma as well as detection of cholesteatoma in hidden areas.…”

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confidence: 99%

Middle ear cholesteatoma: a study of correlation between HRCT temporal bone and intraoperative surgical findings

Chavada¹,

Khavdu²,

Fefar³

et al. 2018

Int J Otorhinolaryngol Head Neck Surg

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INTRODUCTIONCholesteatoma is a long-standing infection of the middle ear cleft. It is a three-dimensional stratified squamous epithelial sac confirming to the middle ear cleft, containing keratin debris and having the capacity for progressive and independent growth at the expense of the underlying bone, displacing or replacing the middle ear mucosa, and has a tendency to recur after removal.1 It has a destructive nature that erodes the bone and causes rapid bone destruction. Cholesteatoma have characteristics of growth, migration and osseous erosion and are thus locally destructive, the only treatment is their full surgical removal since there is no effective clinical treatment for eradication of the disease so far. 2Chronic ear discharge and decreased hearing are most common clinical presentation in cholesteatoma disease. Other symptoms are tinnitus, earache, ear bleeding. Other warning symptoms are headache, high grade fever, vomiting, giddiness and facial asymmetry suggestive of intratemporal and intracranial complications. ABSTRACTBackground: Cholesteatoma is a long-standing infection of the middle ear cleft having erosive properties. Chronic ear discharge and decreased hearing are most common clinical presentation. Multi-directional tomography of high quality can provide a detailed understanding of the interpretation of anatomical structures visualized by HRCT. Knowledge of the anatomical variations and changes induced by pathology in the temporal bone are the guiding marbles for surgery. Methods: This is a prospective study consisted of 100 cases of chronic suppurative otitis media of unsafe type requiring ear surgery admitted in the E.N.T. department of P.D.U. Civil Hospital Rajkot in 2 years from December 2015 to December 2017. A total no. of 100 patients of both gender between 5 to 80 years has been included in the study. Results: In this study, 58% patients were females while males were 42%. Left ear (46%) was involved more as compared to right ear (40%). Most of the patients belonged to 11-20 (25%) years of age group. Mean age is 24.5 years. Most common symptoms were ear discharge (98%) and decreased hearing (83%). Conclusions: HRCT guides the surgeon on the possible surgical hazards before the surgery and helps in earlier management and operative complications. The use of CT in the case of chronic suppurative otitis media does provide valuable information. HRCT scanning is a unique method of detection of early cholesteatoma as well as detection of cholesteatoma in hidden areas. In addition, HRCT scanning serves as a road map to assist the surgeon during cholesteatoma surgery.

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CT scanning of middle ear cholesteatoma: what does the surgeon want to know?

Cited by 50 publications

References 8 publications

Incidence of CSOM Unsafe Type in Rural Population of Central India

Incidence of CSOM Unsafe Type in Rural Population of Central India

The role of computed tomography scanning in chronic otitis media

Middle ear cholesteatoma: a study of correlation between HRCT temporal bone and intraoperative surgical findings

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