Diagnostic efficacy of high-resolution computed tomography findings in patients of chronic suppurative otitis media atticoantral type

Nikki Gajjar, Neena Bhalodiya, Simple Bhadania


Background: High resolution computed tomography (HRCT) provides information about anatomy and pathology of temporal bone and middle ear cleft, thus becoming important imaging modality in diagnosis and pre-operative planning in patients of chronic suppurative otitis media (attico-antral) CSOM (AA) type. The aim of study was to study disease extension and plan surgery accordingly in patients of CSOM (AA) and to study correlation between the HRCT findings and intra-operative findings of CSOM (AA) like soft tissue density mass, ossicular chain erosion, facial canal dehiscence, semi-circular canal erosion.

Methods: Study of 70 patients clinically diagnosed of having CSOM (AA) in period between August 2018 to March 2020 was done at Sola civil hospital, Ahmedabad. All patients were advised HRCT temporal bone except those who had contraindications to CT scan, analysed and operated. Pre-operative CT-scan findings and intra-operative findings were compared for statistical analysis.

Results: Soft tissue density was found in 100% of cases on HRCT temporal bone. Bony erosion seen in 25% of cases. 90% showed ossicular erosion. Lateral semi-circular canal fistula was observed in 10% of cases with facial canal dehiscence in 10% of cases. Intra-operative findings showed accuracy of HRCT in detecting soft tissue density to be 100%; bony erosion was observed in 25% cases. 10% patients had lateral semi-circular canal fistula. Facial canal dehiscence was seen in 15% cases.

Conclusion: HRCT has proved quite useful and reliable to identify the disease extension before surgery and plan surgery accordingly.



HRCT temporal bone, Middle ear, CSOM, Cholesteatoma

Full Text:



Edelstein DR, Parisier SC, ChengHan J. Acquired Cholesteatoma in the Pediatric Age Group. otolaryngol clinics North Am. 1989;22(5):955-66.

Dashottar S, Bucha A, Sinha S, Nema D. Preoperative temporal bone HRCT and intra-operative findings in middle ear cholesteatoma: a comparative study. Int J Otorhinolaryngol Head Neck Surg. 2019;5:77-82.

Happani H, Kalola J, Rathod H, Trivedi A. Role of HRCT temporal bone in patients with chronic supparative otitis media. International Journal of Contemporary Medicine Surgery and Radiology. 2018;3(3):C70-2.

Kanotra S, Gupta R, Gupta N, Sharma R, Gupta S, Kotwal S. Correlation of high-resolution computed tomography temporal bone findings with intra-operative findings in patients with cholesteatoma. Indian J Otol. 2015;21(4)280-85.

Kumar A, Wiet R. Aural complications of otitis media. In Aina Julianna Gulya, Llyod B Minor, Dennis S. Poe. 6th edition Surgery of the Ear. People’s medical publishing house- USA Shelton, Connecticut. 2010.

Rogha M, Hashemi SM, Mokhtarinejad F, Eshaghian A, Dadgostar A. Comparison of Preoperative Temporal Bone CT with Intraoperative Findings in Patients with Cholesteatoma. Iran J Otorhinolaryngol. 2014;26(74):7-12.

Kangsanarak J, Fooanant S, Ruckphaopunt K, Navacharoen N, Teotrakul S. Extracranial and intracranial complications of suppurative otitis media. Report of 102 cases. J Laryngol Otol. 1993;107:999-1004.

Ajalloueyan M. Modified radical mastoidectomy: techniques to decrease failure. Med J Islam Republic Iran. 1999;9:179-83.

Modwal A, Saboo R, Saxena G, Sapra G. A Study of the Correlation of the Clinical Feature, Radiological Evaluation and Operative Finding in CSOM with Cholesteatoma. Sch J App Med Sci. 2014;2(6):3259-69.

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

Chavada PS, Khavdu PJ, Fefar AD, Mehta MR. Middle ear cholesteatoma: a study of correlation between HRCT temporal bone and intraoperative surgical findings. IntJ Otorhinolaryngol Head Neck Surg. 2018;4:1252-7.