Title: Intraoperative and HRCT Findings Correlation in Chronic Suppurative Otitis Media

Authors: Dr Pramod V, Dr Raghuraj U, Dr Shrikrishna U

 DOI: https://dx.doi.org/10.18535/jmscr/v8i2.107

Abstract

   

Objective: 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.

Keywords: Cholesteatoma, CSOM, HRMDCT, Prussack space, Temporal bone.

References

  1. Keskin S, Cetin H et al. The correlation of temporal bone CT with surgery findings in evaluation of chronic inflammatory diseases of the middle ear.Eup J Gen Med.2011; 8(1): 24 -30.
  2. Prabhu Khavasi, Santosh Malashetti, Chandrashekarayya. An evaluation of pre-operative High Resolution Computedn Tomography of the Temporal Bone in Cholesteatoma. Int J. Otorhinolaryngology and Head and Neck Surg. 2018 March; 4(2):413-417.
  3. Poursadegh M, Hashemi G. Evaluation of Anatomical variations of vestibular aqueduct dimensions in temporal bone CTscan.MJIRI.2000; 14(3): 199 -202.
  4. John R Haaga, Daniel T Bell. ‘Temporal Bone’. Chapter 21, CT and MRI of whole body.6th edition. Elsevier India; 2016:614-650.
  5. Payal S Chavada, Manish R. Middle Ear Cholesteatoma: A study of correlation between HRCT temporal bone and intraoperative surgical findings. Intl. J otorhinolarongology. 2018 Sept; 4(5): 1252-57.
  6. Thukral et al. Role of High Resolution Computed Tomography in Evaluation of Pathologies of Temporal Bone Journal of Clinical and Diagnostic Research. 2015 Sept; Vol-9(9): TC07-TC10.
  7. Dwaraknath K. Sirigiri RR. Correlative Study of HRCT in Attico-Antral Disease. Indian J Otolaryngol Head Neck Surg. 2011; 63:155-158.
  8. Alhussini. Zaid H Jumaily. The correlation Between Computed Tomography (HRCT) and intra operative findings of Chronic otitis media. Clinical Medical Insight Ear Nose Throat.2019 July; 12:1-52.
  9. Nanjaraj CP, Nagarajegowda PH, Kannan VP, PKC Nagarajiah. Chronic otitis media: High resolution computed tomographic evaluation of the temporal bone with surgical correlation. J. Evid. Based Med. Healthc, 2016; 3(40): 1955-1962.
  10. Ashu Seith Bhalla, Anuradha Singh, Manisha J. Chronically discharging ears: Evaluation with high resolution computed tomography. Polish J. Radiol. 2017 Aug; 82: 478-89.
  11. P Walsch, R Mc Conn Walsh et al. The role of computerised tomography in the pre-operative assessment of chronic otitis media; Clinical Otolaryngology. 2002 April; 27(2): 95 -97.
  12. Sonika Kanotra, Rohan Gupta. Correlation of high resolution computed tomography temporal bone findings with intra operative findings in patients with cholesteatoma. Ind J. Otology. 2015 June; 21(4):280-285.
  13. Tripthi Rai. Radiological study of the temporal bone in chronic otitis media -Prospective study of 50 cases. Ind J. Otology. 2019 April; 20(2):48-55.
  14. Wang EL, Gu F. Significance of CT in the diagnosis of Chronic Suppurative Otitis Media. J Chinese Medical. 2007July; 42(7): 494-498.
  15. Vinit Kumar Sharma, Neeraj Prajapathi. Radiological changes in anatomy of temporal bone in cases of unsafe chronic suppurative otitis media- A prospective Study. Ind J. Otology. 2017 April; 23(3):176 -179.
  16. Mardassi Ali, Mathlouthi Nabi. Limits of conventional temporal bone computed tomography in the management of cholesteatoma otitis media - Report of 96 cases. Egyptians J Otolaryngology. 2014 May; 30(2): 73 -77.
  17. Payal G et al. Computed Tomography in Chronic Suppurative Otitis Media: Value in Surgical Planning. Indian Journal of Otolaryngology and Head Neck Surgery (2012); 64: 225-240.
  18. Zhang X, Chen Y. CT scan verses surgery: How reliable is the pre-operative radiological assessment in patients with chronic otitis media. J Chinese Medical. 2004 July; 18(7): 396-383.
  19. Sasmita Pravat, Pravat N R. Role of HRCT in temporal bone Diseases: A study of 100 cases. Www/jkscience.org. 2018 March; 20(1): 34 -38.
  20. Karki S, Pokharel M. Correlation between pre-operative High Resolution Computed Tomography (CT) Findings with Surgical findings in chronic otitis media squamous type. J Kathmandu Med Univ. 2017 March; 579(10):83-86.
  21. Amy F Juliano et al. Imaging Review of the Temporal Bone: Part I. Anatomy and Inflammatory and Neoplastic Processes. Radiology RSNA, 2013; 269:17–33.
  22. Hassmann Poznanska et al. Computerized Tomography in pre-operative imaging of middle ear cholesteatoma. J. Otolaryngol Pol. 2003; 57(2): 243-249.
  23. Bernadette Koch, Bronwyn E Hamilton, Patricia Hudgins, H Richarnsberger. Imaging of Temporal Bone,Section 25, Diagnostic Imaging: Head and Neck. 3rd Elsevier India; 2017:1041-1059.
  24. Prakash M.D, Afshan Tarannum. Role of High Resolution Computed Tomography of Temporal Bone in Pre-operative Evaluation of Chronic Supparative Otitis Media. Intn.J Otorhinolaryngology and Head and Neck Surgery. 2018 Sept; 4(5): 1287-1292.
  25. Ashu Seith Bhalla, Anuradha Singh, Manisha J. Chronically discharging ears: Evaluation with high resolution computed tomography.Polish J. Radiol. 2017 Aug; 82: 478-89.

Corresponding Author

Dr Pramod V

Post graduate student, Department of Radio Diagnosis, K.S. Hedge Medical Academy, Nitte University, Mangalore – 575018 Karnataka, India