Details
Category: Volume 08 Issue 04 April 2020
Hits: 1072

Title: A Correlative Study between HRCT Findings with Operative Findings in Chronic Otitis Media with Cholesteatoma

Authors: Dr Ravi Baniya, Dr Vaibhav Kuchhal, Dr Shahzad Ahmad, Dr Varun Rawat, Dr Aakankasha Rawat

 DOI: https://dx.doi.org/10.18535/jmscr/v8i4.24

Abstract

   

Background: Chronic Otitis Media (COM) is a commonly occurring disease worldwide. Timely management is required as this disease is capable of causing serious complications and can lead to long term pain and discharge from the ear. The assessment and management of active squamosal type of chronic otitis media presents many challenging and fascinating problems. Radiologic studies are a valuable aid in the diagnosis and management of ear diseases associated with changes in the osseous structure.

Methods: We conducted a study on 30 patients of 12-58 years of age with complaints of ear discharge and hearing loss. After detailed history, examination and relevant investigation findings were documented. HRCT Temporal bone was done and ear was operated. All pre-operative CT findings was correlated with intraoperative findings.

Results: The CT scan is the standard imaging technique for the temporal bone. Preoperative CT scan is helpful in relation to diagnosis and decision making for surgery in cases of cholesteatoma and ossicular erosion. CT scan accurately predicts the evidence of cholesteatoma. HRCT is precisely helpful in detection of malleus and icus erosion but not helpfull in detection of stapes erosion. It is helpful in detection of extent of disease specially in areas like epitympanum, mesotympanum, mastoid air cells and aditus.

Conclusions: Therefore, it is concluded that CT despite its pitfalls such as more radiation exposure and higher cost delineates the location and extent of cholestaetoma.

Keywords: Chronic otitis media, Cholesteatoma, HRCT temporal bone.

References

  1. Acuin J; Extracts from “Concise clinical evidence”: chronic suppurative otitis media. British Medical Journal 2002; 325; 73: 1159–60.
  2. Mafee MF, Levin BL, Applebaum EL, Campos CF. Cholesteatoma of the middle ear and mastoid. Otolaryngol Clin North Am. 1988; 21:p. 265-8.
  3. Buckingham RA, Vavassori GE. Tomographic evaluation of cholesteatoma of the middle ear and mastoid. Otolaryngol Clin North Am. 1973; 6: p. 363-77.
  4. Glasscock ME, Dickins JRE, Welt R. Cholesteatoma in children. Laryngoscope 1981; 91:p. 1743-53.
  5. Mac Millian AS: radiologic diagnosis of Neuro-otologic problems byconventional radiology. Arch Otolaryngol 1969; 89: p. 78-82.
  6. Brunner S, Peterson O, Sandberg LE. Tomography in cholesteatoma of thetemporal bone. Correlation between the standard roentgenographic examinations and tomography. AJR 1966; 97: p. 588-96.
  7. Coel MN, Godwin D. Simplified plain film screening examination for erosive otitis media. AJR 1979; 133.
  8. Phelps PD, Wright A. Imaging choleste-atoma. Clin Radiol 1990; 41:156-62.
  9. Lin DPC, Bergeron RT. Contemporary radiological imaging in the evaluation of the middle ear – attic – antral complex cholesteatoma. Otolaryngol Clin North Am 1989; 22: 897-09.
  10. Swartz JD, Goodman RS, Russel KB. High resolution computed tomography of the middle ear and mastoid. Part 11: tubotympanic disease. Radiology 1983; 148: 455-9.
  11. Walshe P, McConn. ‘The role of CT in preoperative assessment of CSOM’. ClinOtolaryngol. Allied Sci.2002 Apr; 27 (2):95-7.
  12. Jackler RK, Witham P. Dillon, Schindler RA. Computed tomography insuppurative ear disease: a correlation of surgical and radiographic findings. Laryngoscope 1984; 94:746-52.
  13. Garber LZ, Dort JC. Cholesteatoma: diagnosis and staging by CT scan. J Otolaryngol 1994; 23:121-4. 
  14. Mafee MF, Kumar A, Yannias D. Computed tomography of the middle ear in the evaluation of cholesteatoma and other soft tissue masses: comparison with  Pluridirectional tomography. Radiology 1983; 148:465-72.
  15. Rogha M ,Hashemi SM, Mokhtarinejed F,Eshaghian A,Dadgostar A,Comparison of preoperative temporal bone CT with intraoperative findings in patients with cholesteatoma. Iranian Otorhinolarynology 2014;26(1);7-12
  16. Kanorta S, Gupta R, Gupta N, Sharma R, Gupta S, Kotwal S. Correlation of high-resoluation computed tomography temporal bone findings with intraoperative findings in patients with cholesteatoma .Indian J Otol.2015;21:(4).
  17. Chee NW, Tan TY. The value of pre-operative high resolution CT scans in cholesteatoma surgery. Singapore Med J 2001;42(4):155–9.
  18. Zhang X, Chen Y, Liu Q, Han Z, Li X. The role of high-resolution CT in the preoperative assessment of chronic otitis media. Lin Chuang Er Bi Yan Hou Ke Za Zhi 2004;18:396-8.  
  19. Datta G, Mohan C, Mahajan M, Mendiratta V. Correlation of preoperative HRCT findings with surgical findings in Unsafe CSOM. J Dent Med Sci 2014;13:120-5.
  20. Gerami H, Naghavi E, Wahabi-Moghadam M, Forghanparast K, Akbar MH. Comparison of preoperative computerized tomography scan imaging of temporal bone with the intra-operative findings in patients undergoing mastoidectomy Saudi Med J. 2009 Jan; 30(1):104-8.
  21. Sirigiri RR, Dwaraknath K. Correlativestudy of HRCT in Attico-Antral Disease Indian J Otolaryngol Head Neck Surg. 2011 Apr;63(2):155-8.

Corresponding Author

Dr Vaibhav Kuchhal

Professor and Head of ENT Dept, GMC Haldwani Uttrakhand, India