Role of HRCT Temporal Bone in Diagnosis of Chronic Suppurative Otitis Media in Correlation with Intraoperative Findings

Abstract

This study aims to evaluate the role of preoperative HRCT temporal bone in the diagnosis of the disease, its
extension and complications and plan for surgery. The involved structures and also in knowing prognosis
is compared with Intraoperative findings made by the surgeon to know its precision in diagnosis. It also
helps in diagnosing intracranial complications of CSOM at an early stage and help to plan surgery. Patients
presenting/Suspected to have CSOM who were planned for mastoid exploration surgery in Department
of ENT, within a period of 2 years–from February 2019 to September 2020, were taken up for study. The
patient will undergo HRCT temporal bone with Aquilon 160 slice CT scanner producing sub millimetric thin
axial scans Following areas of interest were looked up in preoperative scans:-
• Pneumatization of mastoid • Extent of disease
• Tegmen tympani erosion • Sinus plate erosion
• Facial canal dehiscence • Lateral semicircular canal dehiscence
• Ossicular status • Disease outside middle ear cleft
Out of total 30 patients of CSOM, 26 (52%) were males. Majority of the patients (70%) were in the age
group of 11 to 30 years. Left ear was involved in 40% of the patients. Majority of the patients (80%)
presented with chief complaints of otorrhoea. In the present study, External Auditory Canal (EAC) was seen
normal in majority of patients (82%) both radio logically and per operatively. HRCT scan was found to be
highly sensitive (100%) in diagnosing cholesteatoma. CT scans diagnosed erosion of malleus with 100%
sensitivity and specificity and erosion of incus with 91% sensitivity and 100% specificity.HRCT has a very
high reliability for diagnosis of erosion of scutum, erosion of ossicles and its disruption, Pneumatization of
mastoid, anterior lying sigmoid, extent of cholesteatoma in the middle ear and MAC. The study concludes
that HRCT can be recommended not just for symptomatic cases but in all suspected cases in knowing the
extent of the disease thereby reducing the morbidity.