Publication: Correlation between Preoperative High Resolution Computed Tomography (CT) Findings with Surgical Findings in Chronic Otitis Media (COM) Squamosal Type
Date
2017
Authors
Journal Title
Journal ISSN
Volume Title
Publisher
Kathmandu University
Abstract
ABSTRACT
Background
The exact role of High resolution computed tomography (HRCT) temporal bone in
preoperative assessment of Chronic suppurative otitis media atticoantral disease still
remains controversial.
Objective
To evaluate the role of high resolution computed tomography temporal bone in
Chronic suppurative otitis media atticoantral disease and to compare preoperative
computed tomographic findings with intra-operative findings.
Method
Prospective, analytical study conducted among 65 patients with chronic suppurative
otitis media atticoantral disease in Department of Radiodiagnosis, Kathmandu
University Dhulikhel Hospital between January 2015 to July 2016. The operative
findings were compared with results of imaging. The parameters of comparison
were erosion of ossicles, scutum, facial canal, lateral semicircular canal, sigmoid and
tegmen plate along with extension of disease to sinus tympani and facial recess.
Sensitivity, specificity, negative predictive value, positive predictive values were
calculated.
Result
High resolution computed tomography temporal bone offered sensitivity (Se) and
specificity (Sp) of 100% for visualization of sigmoid and tegmen plate erosion.
The performance of HRCT in detecting malleus (Se=100%, Sp=95.23%), incus
(Se=100%,Sp=80.48%) and stapes (Se=96.55%, Sp=71.42%) erosion was excellent. It
offered precise information about facial canal erosion (Se=100%, Sp=75%), scutum
erosion (Se=100%, Sp=96.87%) and extension of disease to facial recess and sinus
tympani (Se=83.33%,Sp=100%). high resolution computed tomography showed
specificity of 100% for lateral semicircular canal erosion (Sp=100%) but with low
sensitivity (Se=53.84%).
Conclusion
The findings of high resolution computed tomography and intra-operative findings
were well comparable except for lateral semicircular canal erosion. high resolution
computed tomography temporal bone acts as a road map for surgeon to identify the
extent of disease, plan for appropriate procedure that is required and prepare for
potential complications that can be encountered during surgery.
KEY WORDS
Cholesteastoma, high resolution computed tomography, temporal bone
Description
Karki S, Pokharel M, Suwal S, Poudel R
Department of Radiodiagnosis and Imaging
Kathmandu University School of Medical Sciences
Dhulikhel Hospital, Kathmandu University Hospital
Dhulikhel Hospital, Kavre, Nepal
Keywords
Cholesteastoma, high resolution computed tomography, temporal bone