THE CORRELATION OF THE HIGH-RESOLUTION CT SCAN WITH THE OPERATIVE FINDINGS IN PATIENTS WITH CHRONIC OTITIS MEDIA UNDERGOING TYMPANOMASTOIDECTOMY: A DESCRIPTIVE STUDY

Volume 12 , Issue 2 , June 2022 , Pages 135-142

Authors

Muaid I. Aziz Baban 1

1 Department of Surgery, College of Medicine, University of Sulaimani, Kurdistan Region, Iraq.

DOI logo 10.17656/jsmc.10353

Keywords

Abstract

Background
The prior knowledge of the normal anatomy and disease extension in chronic suppurative otitis media (CSOM)
is essential in the decision-making and planning of their surgical approach. Especially with the development
of high-resolution computed tomography (HRCT), which provides good topographic viewing without the
artefacts caused by the superimposition of structures.
Objectives
To point out the accuracy of the HRCT scan in correlation to intraoperative findings of CSOM diseases in
predicting the disease’s extent and taking surgical decisions.
Patients and Methods
A Prospective study conducted at the Department of Otolaryngology-Head & Neck Surgery (Sulaimani
Teaching Hospital, College of Medicine – the University of Sulaymaniyah, Kurdistan Region –Iraq. Patients
who had CSOM and were listed for mastoid surgery were included in the study. All included patients underwent
HRCT preoperatively, and each image was analyzed on Osirix software to define the anatomical structures.
Evaluation of pathologies of the temporal bone was recorded in a radiology proforma. A similar proforma
itemized the intraoperative findings, compared them to the radiological records, and statistically analyzed
them using the statistical package for social sciences (SPSS, version 19).
Results
Thirty-five patients were included in this study, and their findings showed the significance of sensitivity and
specificity of HRCT in comparison to surgical findings as follows; scutum erosion was 88.9%, 96.9%, ossicle
erosion was 100%, 96%, and 68.4%, 100% for malleus and incus erosion respectively. Moreover, facial nerve
canal erosion with a sensitivity of 28.6% and 92.9% specificity. Lateral semicircular canal (LSSC) erosion
with a sensitivity of 50% and specificity of 93.9%. Tegmen, posterior canal wall, and sigmoid sinus wall
integrity with a sensitivity and specificity of 66.7%/ 96.9%, 83.3%/89.7%, and 100%/ 96%, respectively.
Conclusion
High-resolution computed tomography scan is a valuable modality in the preoperative assessment of temporal
bone pathologies in patients with chronic suppurative otitis media with reasonable accuracy and precision for
taking surgical decisions.

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  • Published at21 June 2022

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