Preoperative high-resolution computed tomography temporal bone evaluation in patients with chronic otitis media-squamous disease and its correlation with intraoperative findings

Authors

  • Ramzia Mohammed Department of Radiodiagnosis, Jubilee Mission Medical College and Research Institute, Thrissur, Kerala, India https://orcid.org/0009-0000-6238-3738
  • Binoj Varghese V. Department of Radiodiagnosis, Jubilee Mission Medical College and Research Institute, Thrissur, Kerala, India
  • Ihsan A. T. Department of Otorhinolaryngology, Jubilee Mission Medical College and Research Institute, Thrissur, Kerala, India

DOI:

https://doi.org/10.18203/issn.2454-5929.ijohns20261502

Keywords:

Chronic otitis media, Squamous disease, HRCT temporal bone, Cholesteatoma, Intraoperative correlation, Diagnostic accuracy

Abstract

Background: Chronic otitis media (COM) with squamous disease is a significant cause of morbidity and may lead to serious intratemporal and intracranial complications if not adequately evaluated. High-resolution computed tomography (HRCT) of the temporal bone plays a key role in preoperative assessment; however, its diagnostic accuracy requires validation with intraoperative findings. Objectives were to evaluate the diagnostic accuracy of HRCT temporal bone in patients with COM-squamous disease and to correlate radiological findings with intraoperative findings.

Methods: This was a hospital-based observational study conducted on 55 patients diagnosed with COM-squamous disease who underwent HRCT temporal bone followed by surgical management. HRCT findings regarding disease extent and bony erosion were compared with intraoperative findings, which were considered the gold standard. Diagnostic performance parameters including sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were calculated.

Results: HRCT demonstrated high sensitivity (96.3%) in detecting disease involvement, with a specificity of 50.0%. The PPV and NPV were 86.7% and 80.0%, respectively. Good correlation was observed between HRCT and intraoperative findings for major bony structures and ossicular erosion. However, reduced accuracy was noted in assessing smaller structures such as the stapes, facial canal, and lateral semicircular canal.

Conclusions: HRCT is a valuable preoperative imaging modality in COM-squamous disease, demonstrating high sensitivity and good correlation with intraoperative findings. Despite limitations in soft tissue differentiation and evaluation of small structures, HRCT remains an essential tool for surgical planning; adjunctive imaging such as MRI may be useful in selected cases.

References

Organization WH. Chronic suppurative otitis media: burden of illness and management options. World Health Organization. 2004. Available at: https://iris.who.int/handle/10665/42941. Accessed on 15 February 2026.

Juliano AF, Ginat DT, Moonis G. Imaging Review of the Temporal Bone: Part II. Traumatic, Postoperative, and Noninflammatory Nonneoplastic Conditions. Radiology. 2015;276(3):655-72.

Baráth K, Huber AM, Stämpfli P, Varga Z, Kollias S. Neuroradiology of cholesteatomas. AJNR Am J Neuroradiol. 2011;32(2):221-9.

Jackler RK, Dillon WP. Computed tomography and magnetic resonance imaging of the inner ear. Otolaryngol Head Neck Surg. 1988;99(5):494-504.

Gaurano JL, Joharjy IA. Middle ear cholesteatoma: characteristic CT findings in 64 patients. Ann Saudi Med. 2004;24(6):442-7.

Corrales CE, Blevins NH. Imaging for evaluation of cholesteatoma: current concepts and future directions. Curr Opin Otolaryngol Head Neck Surg. 2013;21(5):461-7.

Gomaa MA, Abdel Karim AR, Abdel Ghany HS, Elhiny AA, Sadek AA. Evaluation of temporal bone cholesteatoma and the correlation between high resolution computed tomography and surgical finding. Clin Med Insights Ear Nose Throat. 2013;6:21-8

Patel B, Hall A, Lingam R, Singh A. Using Non-Echoplanar Diffusion Weighted MRI in Detecting Cholesteatoma Following Canal Wall Down Mastoidectomy-Our Experience with 20 Patient Episodes. J Int Adv Otol. 2018;14(2):263-6.

Saito Z, Yoshida M, Uchiyama S, Nishioka S, Tamura K, Tamura N. Usefulness of High-resolution Computed Tomography for Macrolide Therapy of Idiopathic Bronchiectasis. Open Respir Med J. 2023;17:e187430642307250

Chatterjee P, Khanna S, Talukdar R. Role of High Resolution Computed Tomography of Mastoids in Planning Surgery for Chronic Suppurative Otitis Media. Indian J Otolaryngol Head Neck Surg. 2015;67(3):275-80.

Singh B, Soni S, Verma V, Baghel DS. Correlation Between Preoperative HRCT Temporal Bone Findings and Intraoperative Findings in Patients with Chronic Otitis Media Active Squamosal Disease. Indian J Otolaryngol Head Neck Surg. 2025;77(2):693-8.

Kumari A, Alam N, Kumar S. High-Resolution Computed Tomography of the Temporal Bone in Chronic Otitis Media: An Observational Study at a Tertiary Care Center in Jharkhand, India. Cureus. 2023;15(8):e42813.

Poswal P, Padiyar BV, Taneja A. Preoperative High Resolution Computed Tomography of the Temporal Bone and its Correlation to Intraoperative Findings in Squamous Chronic Otitis Media–A Prospective Observational Study. Int J Adv Integrated Med Sci. 2018;3(1):18-21.

Kapoor AA, Kapoor A, Nimkar NU, Soni HD, Ojha VS, Biswas R. High-Resolution Computed Tomography and Intraoperative Correlation in Cholesteatoma: Enhancing Preoperative Evaluation and Surgical Management. Cureus. 2023;15(8):e44333.

Sagar NJ, Devasamudra CR. Clinical study of correlation between preoperative findings of HRCT with intra-operative findings of cholesteatoma in cases of CSOM. IP Indian J Anatomy Surg Head Neck Brain. 2017;3(1):1-5.

Karki S, Pokharel M, Suwal S, Poudel R. Correlation between Preoperative High Resolution Computed Tomography (CT) Findings with Surgical Findings in Chronic Otitis Media (COM) Squamosal Type. Kathmandu Univ Med J (KUMJ). 2017;15(57):84-7.

Vlastarakos PV, Kiprouli C, Pappas S, Xenelis J, Maragoudakis P, Troupis G, et al. CT scan versus surgery: how reliable is the preoperative radiological assessment in patients with chronic otitis media? Eur Arch Otorhinolaryngol. 2012;269(1):81-6.

Rocher P, Carlier R, Attal P, Doyon D, Bobin S. Contribution and role of the scanner in the preoperative evaluation of chronic otitis. Radiosurgical correlation apropos of 85 cases. Ann Otolaryngol Chir Cervicofac. 1995;112(7):317-23.

Zhang X, Chen Y, Liu Q, Han Z, Li X. [The role of high-resolution CT in the preoperative assessment of chronic otitis media]. Lin Chuang Er Bi Yan Hou Ke Za Zhi. 2004;18(7):396-8.

Mandal S, Muneer K, Roy M. High Resolution Computed Tomography of Temporal Bone: The Predictive Value in Atticoantral Disease. Indian J Otolaryngol Head Neck Surg. 2019;71(2):1391-5.

Gülay Aslan G, Yagiz Aghayarov O, Pekçevik Y, Arslan IB, Çukurova I, Aslan A. Comparison of tympanometric volume measurement with temporal bone CT findings in the assessment of mastoid bone pneumatization in chronic otitis media patients. Eur Rev Med Pharmacol Sci. 2023;27(5):6-10.

Xun M, Liu X, Sha Y, Zhang X, Liu JP. The diagnostic utility of diffusion-weighted magnetic resonance imaging and high-resolution computed tomography for cholesteatoma: A meta-analysis. Laryngoscope Investig Otolaryngol. 2023;8(3):627-35.

Downloads

Published

2026-05-25

How to Cite

Mohammed, R., V., B. V., & A. T., I. (2026). Preoperative high-resolution computed tomography temporal bone evaluation in patients with chronic otitis media-squamous disease and its correlation with intraoperative findings. International Journal of Otorhinolaryngology and Head and Neck Surgery, 12(3), 384–389. https://doi.org/10.18203/issn.2454-5929.ijohns20261502

Issue

Section

Original Research Articles