A study of radiological assessment of chronic otitis media in both mucosal and squamosal disease
Keywords:High resolution computerised tomography, Temporal bone, Chronic otitis media, Pre-operative assessment
Background: Chronic otitis media (COM) is common disease prevalent in India. Patients coming to OPD who were clinically diagnosed as chronic otitis media (COM) were evaluated using High resolution computerised tomography (HRCT) temporal bone. HRCT temporal bone is highly useful in knowing the disease involving middle ear cleft and adjacent structures. Previous studies have indicated the importance of HRCT temporal bone in mapping anatomy and middle ear disease status in COM patients. The aim of the study was to assess radiological findings of chronic otitis media in both types, and to choose management plan based on the involvement of structures.
Methods: A prospective study was done in 100 COM patients with both mucosal and squamosal disease, using HRCT temporal bone scan and features analyzed.
Results: Among 100 COM patients, 75 had mucosal disease, 25 had squamosal disease. In our study the most common age group was between 16 to 25 years (26%) and 46 to 55 years (24%). The male: female ratio was 2:3. In 100 clinically diagnosed COM participants, 10% of them were found to be radiologically negative. In 90% radiologically positive participants, findings showed radiolucent shadow in the mastoid and middle ear cavity(67%), ossicular involvement(35%) and adjacent structures like epitympanum (22%), hypotympanum (2%), tegmen tympani (3%), Prussak’s space (20%), scutum involvement (18%), sinus tympani (3%), were noted by HRCT.
Conclusions: HRCT temporal bone is a highly reliable diagnostic tool used for preoperative assessment of all COM patients planned for surgery.
Rai T. Radiological study the temporal bone in chronic otitis media: Prospective study of 50 cases. Indian J Otol. 2014;20:48-55.
Bluestone CD. Epidemiology and pathogenesis of chronic suppurative otitis media: implications for prevention and treatment. Int J Pediatr Otorhinolaryngol. 1998;42:207-23.
Gerami H, Naghavi E, Wahabi-Moghadam M, Forghanparast K, Akbar MH. Comparison of pre-operative computerized tomography scan imaging of temporal bone with the intra‑operative findings in patients undergoing mastoidectomy. Saudi Med J. 2009;30:104-8.
Paparella MM, Kim CS. Mastoidectomy update. Laryngoscope. 1977;87:1977-88.
Vlastarakos PV, Kiprouli C, Pappas S, Xenelis J, Maragoudakis P, Troupis G, et al. CT scan versus surgery: How reliable is the pre-operative radiological assessment in patients with chronic otitis media? Eur Arch Otorhinolaryngol. 2012;269:81‑6.
Mafee MF, Levin BC, Applebaum EL, Campos M, James CF. Cholesteatoma of the middle ear and mastoid. A comparison of CT scan and operative findings. Otolaryngol Clin North Am. 1988;21:265-93.
O'Reilly BJ, Chevretton EB, Wylie I, Thakkar C, Butler P, Sathanathan N, et al. The value of CT scanning in chronic suppurative otitis media. J Laryngol Otol. 1991;105:990-4.
Jackler RK, Dillon WP, Schindler RA. Computed tomography in suppurative ear disease: A correlation of surgical and radiographic findings. Laryngoscope. 1984;94:746‑52.
Garber LZ, Dort JC. Cholesteatoma: Diagnosis and staging by CT scan. J Otolaryngol. 1994;23:121-4.
Rocher P, Carlier R, Attal P, Doyon D, Bobin S. Contribution and role of the scanner in the pre-operative evaluation of chronic otitis. Radiosurgical correlation apropos of 85 cases. Ann Otolaryngol Chir Cervicofac. 1995;112:317-23.
Leskinen K, Jero J. Acute complications of otitis media in adults. Clin Otolaryngol. 2005;30:511-6.
Beig S, Khalid S, Sharma SC. Radiographic imaging of mastoid in chronic otitis media: need or tradition? Int J Otorhinolaryngol Head Neck Surg. 2020;6.