Abstract
Aim: To compare pre operative radiological findings (HRCT) with intra operative findings in unsafe CSOM patients.
Materials and Method: 42 cases of unsafe csom were examined clinically and then followed by surgery. HRCT of 0.5 mm sections in both axial and coronal planes was performed in all cases. Considering intra-operative findings as gold standard, a comparison and correlation was made with HRCT temporal bone.
Results: According to this study, HRCT temporal bone can identify structures such as facial nerve canal, dural plate, sinus plate, ossicles and soft tissue mass distribution easily. It is highly sensitive in identifying the condition of ear ossicles, soft tissue mass distribution in middle ear, mastoid pneumatisation, carotid canal and jugular canal with high specificity whereas less specific for facial nerve canal and sigmoid sinus plate erosion.
Conclusion: The present study states that HRCT temporal bone scan plays a very important role in diagnosing unsafe CSOM and its complications preoperative. Despite of a few pitfalls, it plays an excellent role in helping surgeons to plan the type of surgery for each and every case specifically.
Keywords: HRCT temporal bone, Unsafe CSOM, Intra-operative, Ossicles, Temporal bone.
References
- Browning GG, Merchant SN, Kelly G, Swan LRC, Canter R, McKerrow WS (2008) Chronic otitis media. In: Kerr AG (ed) Scott-Brown’s otolaryngology, chap 237c, 7th edn, vol 3. Arnold, London, pp 3395–3445
- Shambaugh JR (1990) Surgery of the ear, surgical management of CSOM, 4th edn. WB Saunders and Co.
- Vlastarakos PV, Kiprouli C, Pappas S, Xenelis J, Maragoudakis P, Troupis G, et al. CT scan versus surgery: how reliable is the pre-operative radiological assessment in patients with chronic otitis media. Eur Arch Otorhinolaryngol. 2012; 269:81–86. doi: 10.1007/s00405-011-1606-y.
- Kennedy K, Vrabec J, Quinn Jr. FB (1999) Cholesteatoma: pathogenesis and surgical management. Department of Otolaryngology, UTMB, Grand Rounds Presentation
- O’Reilly BJ, Chevretton EB, Wylie I, Thakkar C, Butler P, Sathanathan N, et al. The value of CT scanning in chronic suppurative otitis media. J Laryngol Otol. 1991; 105:990–994. doi: 10.1017/S0022215100118031.
- Jackler RK, Dillon WP, Schindler RA. Computed tomography in suppurative ear disease: a correlation of surgical and radiographic findings. 1984; 94:746–752.
- Rocher P, Carlier R, Attal P, Doyon D, Bobin S. Contribution and role of the scanner in the pre-operative evaluation of chronic otitis. Radiosurgical correlation apropos of 85 cases. Ann Otolaryngol Chir Cervicofac. 1995;112:317–323.
- Valvassori GE, Mafee MF. The temporal bone. In: Carter BL, editor. Computed tomography of the head and neck. New York: Churchill Livingstone;
- Magliulo G, Colicchio MG, Appiani MC. Facial nerve dehiscence and cholesteatoma. Ann Otol Rhinol Laryngol. 2011;120:261–267. doi: 10.1177/000348941112000408.
- Vanclooster C,Debruyne F,Vantrappen G,Desllovere C,Leenstra L.Labyrinthine Fistulas in Cholesteatoma Indian Journal of Otology1997; 3:3
- Chee NWC,Tan TY. The Value of Pre-operative High Resolution CT Scans in Cholesteatoma Surgery. Singapore Med J. 2001: 42(2) :155-159
- Tuccar E, Tekdemir I, Aslan A, Elhan A,Deda H. Radiological anatomy of the intratemporal course of facial nerve. Clin Anat 2000; 13:83-87
- O’Donoghue GM. Imaging the temporal bone (Editorial).Clin Otolaryngol.1987; 12:157-160
- Walshe P, McConn Walsh R, Brennan P, Walsh M. The role of computerized tomography in the preoperative assessment of chronic suppurative otitis media. Clin Otolaryngol Allied Sci.2002 Apr;27(2):95-7
- Silver AJ, Janecka I, Wazen J, Hilal SK, Rutledge. Complicated cholesteatomas: Ct findings in inner ear complications of middle ear cholesteatomas. Radiology.1987. Jul; 164:47-51.
- Bates GJEM, O’Donoghue GM, Anslow P, Houlding T.Can CT detect Labyrinthine Fistulae Preoperatively? Acta Otolaryngol (Stockh).1988;106:40-45.
- Briggs RD, GadreA. Differential diagnosis of temporal bone and skull base lesion. QuinnFB,Ryan MW eds. Grand Rounds Presentations, UTMB,Deptt. Of Otolaryngology,
- Banerjee A, Flood LM, Yates P, Clifford K.Computed tomography in suppurative ear disease: does it influence managementlaryngol Otol. 2003; 117(6):454-8.
- Keskin S, Çetin H, Töre HG. The correlation of temporal bone CT with surgery findings in evaluation of chronic inflammatory diseases of the middle ear. Eur J Gen Med. 2011;8:24–30.
- Ballantyne J (ed) (1978) Operative surgery—EAR, 3rd edn. Butterworth, London
Corresponding Author
Dr. H. S. Sharma
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