A study of the correlation between the pre-operative high resolution computed tomography findings and intra-operative findings in chronic otitis media-squamosal type

Authors

  • Gopinathan N. Pillai Department of ENT, Pushpagiri Institute of Medical sciences, Thiruvalla, Kerala, India
  • Anjana Mary Reynolds Department of ENT, Pushpagiri Institute of Medical sciences, Thiruvalla, Kerala, India
  • Melwin Tom Department of ENT, Pushpagiri Institute of Medical sciences, Thiruvalla, Kerala, India

DOI:

https://doi.org/10.18203/issn.2454-5929.ijohns20200056

Keywords:

Chronic otitis media squamosal, Pre-operative HRCT, Temporal bone, Cholesteatoma, Operative findings

Abstract

Background: Chronic otitis media (COM) is characterized by ear discharge and hearing loss. There are two types of COM depending on the presence or absence of cholesteatoma. COM with cholesteatoma is termed as COM squamosal type and COM without cholesteatoma is termed COM mucosal type. COM squamosal type is associated with potential complications. If cholesteatoma is detected early, less invasive surgical methods can be used for hearing preservation and make ear safe from recurrent infections. A proper clinical examination can most often diagnose a cholesteatoma but require a high resolution computed tomography (HRCT) scan to assess the extent of the disease and potential complications. But most often the intra operative findings may not correlate with the HRCT findings. The aim of the study was to evaluate the clinical presentation of COM squamosal disease, preoperative HRCT and intra-operative findings and formulate a proper surgical intervention to avoid complications.  

Methods: This is a comparative study of the pre-operative HRCT and intra-operative findings in COM squamosal type. In the present study of 35 patients with squamosal disease, the HRCT findings were compared with intra-operative findings.

Results: The study showed a good correlation between pre-operative HRCT of temporal bone and intra operative finding. The findings are statistically significant (p<0.001).

Conclusions: The study shows a good correlation between pre-operative HRCT temporal bone and intra-operative findings.

Author Biography

Anjana Mary Reynolds, Department of ENT, Pushpagiri Institute of Medical sciences, Thiruvalla, Kerala, India

Assistant Professor,Department of ENT

References

Wahid FI, Khan IA. Complications of chronic suppurative otitis media, challenge for developing countries. Kulak Burun Bogaz Ihtis Derg. 2014;24(5):265-70.

Valvassori GE. Imaging of the temporal bone. In: Glasscock ME, Gullllya AJ. Glasscock-Shambaugh Surgery of the ear. 5th ed. Ontario: BC Decker Inc; 2003: 227-259.

Shah C, Shah P, Shah S. Role of HRCT temporal bone in pre-operative evaluation of cholesteatoma. Int J Med Sci Public Health. 2014;3:69-72.

Aquino JE, Cruz Filho NA, Aquino JN. Epidemiology of middle ear and mastoid cholesteatoma: study of 1146 cases. Braz J Otorhinolaryngol. 2011;77(3):341-7.

Jothiramalingam SB, Kumar D, Kumar P, Sasindran V, Kumar N. Atticoantral disease- revisited. Indian J Otolaryngol Head Neck Surg. 2007;59:203-6.

Bluestone CD, Klein JO. Intracranial complications and sequlae of otitis media. In: Bluestone CD. Paediatric Otolaryngology. 2nd ed. Philadelphia: W B Saunders; 1990: 738-740.

Mafee MF, Levin BC, Applebaum EL, Campos M, James CF. Cholesteatoma of middle ear and mastoid. A comparison of CT scan and operative findings. Otolaryngol Clin N Am. 1988;21(2):265-93.

Liu DP. Bergeron RT. Contemporary radiologic imaging in the evaluation of middle ear-attic-antral –complex cholesteatomas. Otolaryngol Clin N Am. 1989;5:897-909.

Anbarasu A. Chandrasekaran K, Balakrishnan S. Soft tissue attenuation in middle ear on HRCT: Pictorial review. The Indian Journal of radiology & imaging. 2012;4:298-304.

Prata AA, Antunes ML, de Abreu CE, Frazatto R, Lima BT. Comparative study between radiological and surgical findings of chronic otitis media. Arquivos Internacionais de Otorrhinolaryngologia. 2011;15(1):72-8.

Jackler RK, Dillon WP, Schindler RA. Computed tomography in suppurative ear diseases: a correlation of surgical and radiographic findings. The Laryngoscope. 1984;94(6):746-52.

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

Park KH, Park SI, Kwon J, Kim YM, Park IY, Sung KJ. High resolution computed tomography of cholesteatomatous otitis media: significance of preoperative information. Yonsei Med J. 1988;29(4):367-72.

Sharma VK, Prajapati N, Sharma R, Iqbal Z, Dadoo S. Radiological changes in anatomy of temporal bone in cases of unsafe chronic suppurative otitis media: A retrospective study. Indian J Otol. 2017;23(3):176-9.

Yildirim-Baylan M, Ozmen CA, Gun R, Yorgancilar E, Akkus Z, Topcu I. An evaluation of preoperative computed tomography on patients with chronic otitis media. Indian J Otolaryngol Head Neck Surg. 2012;64(1):67-70.

Payal G, Pranjal K, Gul M, Mittal MK, Rai AK. Computed tomography in chronic suppurative otitis media: value in surgical planning. Indian J Otolaryngol Head Neck Surg. 2012;64(3):225-9.

Rogha M, Hashemi SM, Mokhtarinejad F, Eshaghian A, Dadgostar A. Comparison of preoperative temporal bone CT with intraoperative findings in patients with cholesteatoma. Iranian J Otorhinolaryngol. 2014;26(1):7-12.

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Published

2020-01-24

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Original Research Articles