THE CORRELATION OF THE HIGH-RESOLUTION CT SCAN WITH THE OPERATIVE FINDINGS IN PATIENTS WITH CHRONIC OTITIS MEDIA UNDERGOING TYMPANO-MASTOIDECTOMY: A DESCRIPTIVE STUDY
DOI:
https://doi.org/10.17656/jsmc.10353Keywords:
Chronic suppurative otitis media, High-resolution CT scan, Temporal bone, Tympano-mastoid surgeryAbstract
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.
References
Ginni D, Mohan C, Monika M, Vandana M Correlation of preoperative HRCT findings with surgical findings in Unsafe CSOM, IOSR Journal of Dental and Medical Sciences, 2014; 13 (1): 120‑125. DOI: 10.9790/0853-1319120125 DOI: https://doi.org/10.9790/0853-1319120125
Meredith EA, Hussam KE: Tympanoplasty and Ossiculoplasty. In: Paul W. Flint. [et al.], editors. Cummings otolaryngology head and neck surgery.5th edition. TimPhelps; 2010.p 2000-2005.
Wright T, Valentine P. The anatomy and embryology of external and middle. In Gleeson M., editor. Scott-Brown Otolaryngology-Head and Neck Surgery. 7th edition. Hodder Arnold: London, 2008: Volume3: p 3105- 3122. DOI: https://doi.org/10.1201/b15118-248
Iurato S, Arnold W, Dobritz M. Basics. In: Anniko M, Bernal-Sprekelsen M, Bonkowsky V. Bradley P, Iurato S (eds.). Otorhinolaryngology, Head and Neck Surgery. European Manual of Medicine. Springer, Berlin, Heidelberg, 2010; 1: 3-32. https://doi.org/10.1007/978-3-540-68940-9_1 DOI: https://doi.org/10.1007/978-3-540-68940-9_1
Browning GG, Burton MJ, Clarke R, Hibbert J, Jones NS, Lund VJ, et al. Chronic otitis media. In: Gleeson M, editor. Scott-Brown’s Otorhinolaryngology-Head and Neck Surgery. 7th ed.: Hodder Arnold; 2008. p. 3396. DOI: https://doi.org/10.1201/b15118-85
Howard JD, Elster AD, May JS. Temporal bone: three-dimensional CT. Part II. Pathologic alterations. Radiology. 1990 Nov;177(2):427-30. doi: 10.1148/radiology.177.2.2171013. PMID: 2171013. DOI: https://doi.org/10.1148/radiology.177.2.2171013
Chakeres DW, Augustyn MA. Temporal bone. In: Haaga JR., Lanzieri CF, Gilkeson RC. CT and MR Imaging of the Whole Body. 4th ed. Ohio, Mosby, 2003: 495-512.
Thukral CL, Singh A, Singh S, Sood AS, Singh K. Role of High-Resolution Computed Tomography in Evaluation of Pathologies of Temporal Bone. J Clin Diagn Res. 2015 Sep;9(9): TC07-10. Doi: 10.7860/JCDR/2015/12268.6508. DOI: https://doi.org/10.7860/JCDR/2015/12268.6508
Rajat A, Rabindra P, Heempali DD, Sharma P. Correlation of Preoperative Temporal Bone CT Scan Findings with Intraoperative Findings in Chronic Otitis Media: Squamous Type. Indian J Otolaryngol Head Neck Surg, 2020. 18:21:45 Z. https://doi.org/10.1007/s12070-020-01805-0. DOI: https://doi.org/10.1007/s12070-020-01805-0
Mafee MF, Singleton EL, Valvassori GE, Espinosa GA, Kumar A, Aimi K. Acute otomastoiditis and its complications: role of CT. Radiology. 1985 May;155(2):391-7. doi: 10.1148/radiology.155.2.3983389. PMID: 3983389. DOI: https://doi.org/10.1148/radiology.155.2.3983389
Mafee MF. MRI and CT evaluate acquired and congenital cholesteatomas of the temporal bone. J Otolaryngol. 1993 Aug;22(4):239-48. PMID: 8230374.
Mafee MF, Valvassori GE. Imaging of the temporal bone. In: James BS et al. editors. Ballenger’s Otolaryngol Head Neck Surg. 17th ed. Shelton, Conn.; Hamilton, Ont.; London: People's Medical Pub. House/B C Decker, 2009: 17: P145–171.
Cundiff JG, Djalilian HR, Mafee MF Bilateral sequential petrous apicitis secondary to an anaerobic bacterium. Otolaryngol Head Neck Surg. 2006: 135(6):969–971. 10.1016/j.otohns.2005.05.004. PMID: 17141098. DOI: https://doi.org/10.1016/j.otohns.2005.05.004
Bathla M, Doshi H, Kansara A. Is Routine Use of High-Resolution Computerized Tomography of Temporal Bone in Patients of Atticoantral Chronic Suppurative Otitis Media without Intracranial Complications Justified? Indian J Otolaryngol Head Neck Surg. 2018 Mar;70(1):79-86. doi: 10.1007/s12070-017-1103-8. Epub 2017 Feb 7. PMID: 29456948; PMCID: PMC5807279. DOI: https://doi.org/10.1007/s12070-017-1103-8
Vlastarakos PV, Kiprouli C, Pappas S, Xenelis J, Maragoudakis P, Troupis G, Nikolopoulos TP. CT scan versus surgery: how reliable is the preoperative radiological assessment in patients with chronic otitis media? Eur Arch Otorhinolaryngol. 2012 Jan;269(1):81-6. doi: 10.1007/s00405-011-1606-y. Epub 2011 Apr 24. PMID: 21516503. DOI: https://doi.org/10.1007/s00405-011-1606-y
Howard JD, Elster AD, May JS. Temporal bone: three-dimensional CT. Part I. Normal anatomy, techniques, and limitations. Radiology. 1990 177(2):421–425. doi: 10.1148/radiology.177.2.2217779. PMID: 2217779. DOI: https://doi.org/10.1148/radiology.177.2.2217779
Majeed J, Sudarshan Reddy L. Role of CT Mastoids in the Diagnosis and Surgical Management of Chronic Inflammatory Ear Diseases. Indian J Otolaryngol Head Neck Surg, 2017:69(1):113–120. DOI 10.1007/s12070-016-1023-z. DOI: https://doi.org/10.1007/s12070-016-1023-z
Tatlipinar A, Tuncel A, Öğredik EA, Gökçeer T, Uslu C. The role of computed tomography scanning in chronic otitis media. Eur Arch Otorhinolaryngol. 2012 Jan;269(1):33-8. doi: 10.1007/s00405-011-1577-z. Epub 2011 Mar 24. PMID: 21431950. DOI: https://doi.org/10.1007/s00405-011-1577-z
Walshe P, McConn Walsh R, Brennan P, Walsh M. The role of computerised tomography in the preoperative assessment of chronic suppurative otitis media. Clin Otolaryngol 2002;27(2): 95–7. doi: 10.1046/j.1365-2273.2002.00538. x. PMID: 11994113. DOI: https://doi.org/10.1046/j.1365-2273.2002.00538.x
Yates PD, Flood LM, Banerjee A, Clifford K. CT scanning of middle ear cholesteatoma: what does the surgeon want to know? Br J Radiol 2002; 75(898):847–52. doi: 10.1259/bjr.75.898.750847. PMID: 12381695. DOI: https://doi.org/10.1259/bjr.75.898.750847
Badran K, Ansari S, Al Sam R, Al Husami Y, Iyer A. Interpreting preoperative mastoid computed tomography images: comparing the operating surgeon, radiologist and operative findings. J Laryngol Otol. 2016 Jan;130(1):32-7. doi: 10.1017/S0022215115002753. PMID: 26745138. DOI: https://doi.org/10.1017/S0022215115002753
Rai T Radiological study of the temporal bone in chronic otitis media: a prospective study of 50 cases. Indian J Otol. 2016; 20(2):48–55. doi:10.4103/0971-7749.131865 DOI: https://doi.org/10.4103/0971-7749.131865
Valvassori GE, Hemmati M Imaging of the temporal bone. In: Gulya AJ, Minor LB, Poe DS (eds) Glasscock-Sham- Baugh ear surgery, 6th edn. PMPH—USA CBS, Shelton, 2010: p 267
Phelps PD Radiology of the ear. In: John B, Booth JB (eds) Otology, Scott-brown’s otolaryngology, vol 3, 6th edn. Butter- worth-Heinemann, Oxford, 1997: p 3
Watts S, Flood LM, Clifford K. A systematic approach to interpreting computed tomography scans before surgery of middle ear cholesteatoma. J Laryngol Otol. 2000 Apr;114(4):248-53. doi: 10.1258/0022215001905454. PMID: 10845037. DOI: https://doi.org/10.1258/0022215001905454
Rogha M, Hashemi SM, Mokhtarinejad F, Eshaghian A, Dadgostar A. Comparison of Preoperative Temporal Bone CT with Intraoperative Findings in Patients with Cholesteatoma. Iran J Otorhinolaryngol. 2014 Jan;26(74):7-12. PMID: 24505568; PMCID: PMC3915063.
Kavzoglu T. Object-Oriented Random Forest for High-Resolution Land Cover Mapping Using Quickbird-2 Imagery. In: Pijush Samui, Sanjiban Sekhar, Valentina E. (Eds). Balas, Handbook of Neural Computation, Academic Press, 2017, Pages 607-619, ISBN 9780128113189, https://doi.org/10.1016/B978-0-12-811318-9.00033-8. DOI: https://doi.org/10.1016/B978-0-12-811318-9.00033-8
Chee NW, Tan TY. The Value of Preoperative High-resolution CT scans in Cholesteatoma surgery. Singapore Med J. 2001;42(4):155-59. PMID: 11465314.
Gerami H, Naghavi E, Wahabi-Moghadam M, Forghanparast K, Akbar MH Comparison of preoperative computerised tomography scan imaging of temporal bone with the intra-operative findings in patients undergoing mastoidectomy. Saudi Med J (2009); 30(1):104–108. PMID: 19139782.
Alzoubi FQ, Odat HA, Al-Balas HA, Saeed SR. The role of preoperative CT scan in patients with chronic otitis media. Eur Arch Oto-Rhino-Laryngology. 2009: 266(6):807–809. doi: 10.1007/s00405-008-0814-6. Epub 2008 Sep 18. PMID: 18802717. DOI: https://doi.org/10.1007/s00405-008-0814-6
Sirigiri RR, Dwaraknath K. Correlative Study of HRCT in Attico-Antral Disease. Indian J Otolaryngol Head Neck Surg. 2011 Apr;63(2):155-8. doi: 10.1007/s12070-011-0162-5. Epub 2011 Feb 23. PMID: 22468253; PMCID: PMC3102163. DOI: https://doi.org/10.1007/s12070-011-0162-5
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