Limits of conventional temporal bone computed tomography in the management of cholesteatoma otitis media: Report of 96 cases

Mardassi, Ali; Nabil, Mathlouthi; Safa, Kdous; Mezri, S.; Cyrine, Zgolli; Ghassen, Chebbi; Rania, Ben Mhamed; Akkari, K.; Sonia, Benzarti

doi:10.4103/1012-5574.133174

Cited by 4 publications

(8 citation statements)

References 19 publications

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“…Majority of false negatives (4 cases) were seen in tubotympanic type. Hence HRCT had less sensitivity of 76% but high specificity of 86.6% in detecting the ossicular erosion and these findings are in concurrence with earlier study 16 . HRCT has shown a less sensitivity 72.3 % but high specificity 83.3% in the detection of stapes erosion.…”

Section: Resultssupporting

confidence: 91%

“…All 12 cases detected tegmen erosion on HRCT showing high sensitivity and specificity of 100%. These findings are in concurrence with other studies 24. However, in Mardassi Ali et al 16 study had poor sensitivity of 60% and were mostly seen in pars tensacholesteatoma unlike 70% sensitivity reported in Prabhu et al 2 study. Studies 17 quoted that tegmen and dural plate erosion helps to decide surgical approach based on tympanic membrane and compartment involved.…”

Section: Resultsmentioning

confidence: 79%

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Intraoperative and HRCT Findings Correlation in Chronic Suppurative Otitis Media

V¹

2020

jmscr

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The present study was undertaken to assess diagnostic role of High Resolution Multi-detector Computed Tomography (HRMDCT) of temporal bone in the evaluation of Chronic Suppurative Otitis Media (CSOM) and to correlate intraoperative and HRCT findings in CSOM in selective cases Material and Methods: In our prospective study, a total of 57 who presented with CSOM and referred to Radiodiagnosis department were included in this study. The suspected patients were subjected to HRMDCT of Temporal bone using GE Bright speed Elite16 multi slice CT machine with 0.6mm plain axial and coronal slices with multiplanar reformations. Results: The reported findings were correlated with clinical and surgical findings in subset of cases. Sensitivity, Specificity of HRMDCT with respect to clinical and surgical correlation in selective cases was evaluated. Among 30 surgical cases, most of them were atticoantral (53.4%) followed by tubotympanic CSOM (46.6%). On surgical correlation, HRCT has a high sensitivity (84.36%), specificity (80%), PPV of 90.4% and accuracy of 90% in the diagnosis of type of CSOM. A significant association with p value<0.05 was seen for cholesteatoma, ossicle, bone, masotoiditis, scutum, tegmen and prussack space involvement. HRCT had a high sensitivity and specificity in detection of cholesteatoma (86.4%, 88.9%). Conclusion: HRCT of Temporal bone has a good sensitivity, specificity in the diagnosis of type of CSOM with respect to surgical correlation. HRCT of Temporal bone affords essential information regarding the disease extent, associated complications, aiding clinicians in deciding the appropriate surgical planning and management, thereby making HRMDCT an essential pre workup diagnostic tool.

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Section: Resultssupporting

confidence: 91%

Section: Resultsmentioning

confidence: 79%

Intraoperative and HRCT Findings Correlation in Chronic Suppurative Otitis Media

V¹

2020

jmscr

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“…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].…”

Section: Numbermentioning

confidence: 99%

“…When the surgeon has good knowledge of temporal bone anatomy and its relationship with the adjacent structures mentioned above, s/he can decide on the type of surgery (i.e., open or closed technique) and inform the patient about possible complications. However, the sensitivity of HRCT is low in the detection of preoperative FCD; thus, some authors have suggested that routine preoperative HRCT examination prior to uncomplicated COM surgery was of questionable value [14,17,20,21]. Therefore, in addition to having good knowledge of anatomy, the surgeon must also consider the conditions in which the FCD rates may be high.…”

Section: Introductionmentioning

confidence: 99%

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

Baklacı¹,

Kuzucu²,

Güler³

et al. 2020

Cureus

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“…HRCT accurately predicted LSCC fistula with excellent sensitivity and good specificity. Mardassi Ali 23 also states that LSCC is the most common semicircular canal to be eroded in cholesteatoma because of its close proximity to the medial wall of attic anatomically. Similar incidence also noted by Chuni Lal Thukral et al 3 who reported sensitivity and specificity of 100% and 97.73% 26 , and Rocher et al 20 reported HRCT to be 100% sensitive.…”

Section: Discussionmentioning

confidence: 99%

High Resolution CT Imaging in Pathologies of Temporal Bone

Chidambaram¹,

R²,

Vinayagam³

et al. 2019

IJCMSR

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This was a prospective study, done in our institution from January 2016 to August 2017 with a sample size of 90, after due clearance from the institutional ethical committee. Written informed consent was obtained from all patients prior to the study procedure or data collection. Patients of all age group with ear complaints, such as hearing loss, pain, vertigo, ear discharge and tinnitus referred for HRCT temporal bone were included. Patients with a recent history A B S T R A C T Introduction: Diseases of the ear are a common clinical problem, encountered in every day. Clinical examination alone is not sufficient in present days, owing to prevalence, complications and recurrence of various pathologies of the temporal bone, imaging plays a major role in the management and influences the treatment. High-resolution computed tomography (HRCT) offers an excellent resolution, allowing a better understanding of the aetiology, pathology, disease course with early detection of complications. The prospective study aimed to study pathologies of the temporal bone along with their complications on HRCT and to correlate with their surgical findings. Material and Methods: A prospective study done with a sample size of 90 patients with ear complaints, such as hearing loss, pain, vertigo, ear discharge and tinnitus and referred for HRCT temporal bone were included. Ear trauma and head injury, pregnant women and those unwilling to give consent were excluded. HRCT was done using a GE 128 Slice CT scanner and were followed up for surgical or medical methods of management. Images are reconstructed in the ultra-sharp bone algorithm for image reconstruction, analysed for reporting. The intraoperative findings such as middle ear soft tissue density, ossicular erosion, erosion of scutum, tegmen tympani and facial canal, fistulous communication between the middle ear and lateral and posterior semicircular canal. Above findings were analyzed using standard statistical methods. Results: There is an excellent radio-surgical correlation in diagnosing and differentiating cholesteatoma from granulation tissue, identifying malleus erosion, incus erosion, tegmen tympani erosion, scutum erosion, EAC erosion, sigmoid plate dehiscence, high riding jugular bulb, mastoid status/erosion. Moderate to poor radio-surgical correlation was noted in identifying LSCC fistula, stapes erosion and facial canal erosion. Conclusion: HRCT is a valuable imaging modality through which pre-operative assessment of temporal bone pathologies can be done efficiently with reasonable accuracy, cost and precision for making surgical decisions. Hence it helps the surgeon to decide the course of action in particular clinical problem.

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Limits of conventional temporal bone computed tomography in the management of cholesteatoma otitis media: Report of 96 cases

Cited by 4 publications

References 19 publications

Intraoperative and HRCT Findings Correlation in Chronic Suppurative Otitis Media

Intraoperative and HRCT Findings Correlation in Chronic Suppurative Otitis Media

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

High Resolution CT Imaging in Pathologies of Temporal Bone

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