Role of high resolution computed tomography of temporal bone in management of chronic suppurative otitis media


  • Jaiprakash Tak Department of Otorhinolaryngology, JLN Government Hospital, Nagaur, Rajasthan, India
  • Ajeet Kumar Khilnani Department of Otorhinolaryngology, GMERS Medical College and Hospital, Dharpur, Patan, Gujarat, India



Cholesteatoma, Chronic suppurative otitis media, HRCT temporal bone, Sensitivity, Specificity


Background: High Resolution Computed Tomography (HRCT) has widely replaced conventional techniques (X-Ray Mastoid bone) for temporal bone imaging. The most significant use of computed tomography lies in evaluation of cases of Chronic Suppurative Otitis Media (CSOM). The objective of the study was to evaluate the usefulness of HRCT scanning of temporal bone in defining the extent and severity of disease in patients with CSOM, thereby altering the surgical plan and outcome.

Methods: This prospective study was conducted at a tertiary care hospital in Ahmedabad. After obtaining approval from IEC (Institutional Ethical Committee), study was carried out on 50 patients diagnosed with CSOM of attico-antral type. Written informed consent of all patients was taken before enrollment in the study. HRCT scan findings were reviewed and correlated with per-operative findings.

Results: Out of total 50 patients of CSOM, 26 (52%) were males. Majority of the patients (70%) were in the age group of 11 to 30 years. Left ear was involved in 40% of the patients. Majority of the patients (80%) presented with chief complaint of otorrhoea. In the present study, External Auditory Canal (EAC) was seen normal in majority of patients (82%) both radio logically and per operatively. HRCT scan was found to be very sensitive (96%) in diagnosing cholesteatoma. The sensitivity of HRCT for diagnosing disease in epitympanum, antrum and aditus was found to be 100%, 97% and 88% respectively. CT scans diagnosed erosion of malleus with 100% sensitivity and specificity and erosion of incus with 91% sensitivity and 100% specificity.

Conclusions: HRCT was helpful in determining the anatomy of the middle ear and mastoid, and accurately predicted the extent of the disease process of CSOM. 


Swartz JD, Goodman RS, Russell KB, et al. High resolution computed tomography of the middle ear and mastoid. Part II tubotympanic disease. Radiology. 1983;148:455-9.

Watts S, Flood LM, Cifford K. A systemic approach to interpretation of computed tomography scans prior to surgery of middle ear cholesteatoma. J Laryngol Otology. 2000;114:454-8.

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;27:95-7.

O’Donoghue GM, Bates GJ, Anslow P, Rothera MP. The predictive value of high resolution computerized tomography in chronic suppurative ear disease. ClinOtolaryngol Allied Sci. 1987;12:89-96.

Garber LZ, Dort JC. Cholesteatoma: diagnosis and staging by CT scan. J Otolaryngol. 1994;23(2):121-4.

Jackler RK, Dillon WP, Schindler RA. Computed tomography in suppurative ear disease: a correlation of surgical and radiographic findings. Laryngoscope. 1984;94:746-52.

O’Reilly BJ, Chevretton EB, Wylie I et al. The value of CT scanning in chronic suppurative otitis media. J LaryngolOtol. 1991;105(12):990-4.

Phelps PD, Wright A. Imaging cholesteatoma. Clin Radiol. 1990;41:156-62.






Original Research Articles