Comparison of preoperative high resolution computerized tomography of temporal bone with intra-operative findings in patients with cholesteatoma
DOI:
https://doi.org/10.18203/issn.2454-5929.ijohns20210496Keywords:
Cholesteatoma, Computed tomography scan, Correlation, Sensitivity, SpecificityAbstract
Background: Aim was to study the correlation between high resolution computed tomography (HRCT) scan and intraoperative findings during surgery in cases of chronic otitis media with cholesteatoma.
Methods: This was a descriptive study conducted on 72 patients with acquired cholesteatoma at Govt TD Medical College, Alappuzha for a period of 18 months. All the patients were subjected to HRCT of the temporal bone. Radiological correlation was done with the intra-operative findings. Sensitivity, specificity, positive and negative predictive values were calculated.
Results: Total 24 (33.3%) patients had holotympanic cholesteatoma, 21 (29.2%) had involvement of the attic alone and 16 (22.2%) had attic and antrum involved. 100% correlation was found with bony wall erosions, whereas 96.9% and 75% sensitivity were noted in incus and stapes erosions respectively. 100% specificity was obtained in facial canal and sinus plate erosion, while a specificity of 96.9% in tegmen erosion and 98% in were seen in malleus erosion. By chi square test the difference in correlation was not significant (p value>0.01). Good correlation was seen for lateral semicircular canal fistula. Contrast CT is more specific, but MRI with diffusion weighted sequences is the best in imaging cholesteatoma, especially residual lesions.
Conclusions: Good correlation was found between HRCT scan and intra-operative findings in cases of cholesteatoma in relation to bony wall erosion of the surrounding structures. CT scan alone cannot differentiate soft tissue masses.
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