Clinicoradiological correlation between preoperative high-resolution computed tomography findings and intraoperative findings in chronic otitis media (squamous type)
Keywords:HRCT, Chronic otitis media, Cholesteatoma, Radiosurgical agreement
Background: Chronic otitis media is a major health problem with significant morbidity. High-resolution computed tomography (HRCT) is extremely useful for middle ear pathology and extension of the disease. The objective was to study the correlation between preoperative HRCT and intraoperative findings in chronic suppurative otitis media (squamous type).
Methods: This analytical study included 61 cases of chronic otitis media (squamous type). Preoperative HRCT findings were correlated with intraoperative findings. Sensitivity, specificity, PPV, NPV and kappa value were estimated.
Results: Out of 61 cases 32 were males and 29 were females. Presence of cholesteatoma found on HRCT with 80% sensitivity with k value 0.83 suggesting very good agreement. About ossicular status k value of incus, malleus and stapes were 0.76, 0.65 and 0.54 respectively with sensitivity of 91%, 85% and 58% respectively. Other critical areas on HRCT like sigmoid sinus plate erosion, tegmen tympani dehiscence, scutum erosion, lateral semicircular canal erosion, facial canal erosion and jugular bulb were seen with k value was about 1, 0.8, 0.9, 0.82, 0.72 and 0.65 respectively. So, HRCT shows perfect radiosurgical agreement for sinus plate erosion, very good agreement for disease extension, incus erosion, tegmen tympani erosion, scutum erosion and LSCC erosion and fair agreement for malleus erosion, facial canal erosion and jugular bulb dehiscence and poor agreement for stapes erosion.
Conclusions: HRCT is a reliable preoperative investigation in cases of chronic otitis media, squamosal type which would provide a bird’s eye view in the disease process in the ear.
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