DOI: http://dx.doi.org/10.18203/issn.2454-5929.ijohns20190046

A cross sectional study to assess the role of preoperative HRCT temporal bone in CSOM: a comparison between middle ear surgeries with and without pre-op HRCT

Madhuri S. More, Rahul B. Patel, Jaymin A. Contractor, Alpa P. Pipaliya, Esha J. Desai, Bhavik M. Patel

Abstract


Background: Importance of HRCT before middle ear surgery is proved by many published articles but most of the studies were done without evaluating the accuracy of clinical judgment at the same time.

Methods: All the patients of CSOM in whom the middle ear surgery was planned were included in the study. Total number of sample size was 80 patients. Group A: 20 patients in which HRCT temporal bone was indicated as a routine evaluation before middle ear surgeries. Group B: 60 patients in which HRCT temporal bone was not indicated.  

Results: Maximum 43.75% (35) patients belong to 21 to 30 yrs. F: M is 1.5:1. Unilateral ear disease is more common (62.5%). 41.8% had mucosal type while 16.25% had squamosal type of COM. 77.5% ears found to have hearing loss. Conductive hearing loss was the most common (43.13%). HRCT in comparison with Intra-op had Kapa value of 1 (Aditus blockage & Tegmen erosion), 0.6 (sinus plate erosions), 0.5 (malleus, Incus, stapes erosions), 0.48 (Ossicular chain status), 0.46 (Scutum erosion), 0.4 (LSC fistula) and 0.3 (fallopian canal erosions. Clinical judgment in comparison with intra-op had kapa value of 1 (stapes erosion), 0.96 (aditus blockage), 0.79 (Incus erosion), 0.78 (malleus erosion) and 0.76 (ossicular chain status).

Conclusions: Clinical judgment is as good as or even better than CT in presuming/detecting at least individual ossicular erosions, ossicular chain status, aditus blockage and HRCT temporal bone should be reserved for high risk and complicated cases.


Keywords


CSOM, Middle ear surgery, HRCT temporal bone

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References


Happani H, Kalola J, Rathod H, Trivedi A. Role of HRCT temporal bone in patients with chronic supparative otitis media. International J Contemporary Med Surg Radiol. 2018;3(3):70-2.

Zaid J. Efficacy of pre-operative computed tomography scans on clinical management and temporal bone surgery in cases of chronic otitis media (Dissertation on intrnet) Toronto Boston University 2014. Available at: http://open.bu.edu

Chatterjee P, Khanna S, Talukdar R. Role of high resolution computed tomography of mastoids in planning surgery for chronic suppurative otitis media. Ind J Otolaryngol Head Neck Surg. 2015;67(3):275-80.

Deviana, Dyah I. Pattern and Degree of Hearing Loss in Chronic Suppurative Otitis Media. IOSR-JDMS. 2016;15(3):73-80.

Thukral C, Singh A, Singh S, Sood A, Singh K. Role of High Resolution Computed Tomography in Evaluation of Pathologies of Temporal Bone J Clin Diagn Res. 2015;9(9):7–10.

Sandeep S, Raghavendra K, Prakash B, Shetty T. How Safe is Safe Ear? A Hospital Based Study. IJCC. 2014;2(2):31-4.

Vallabhaneni R, Srinivasa B. HRCT Temporal Bone Findings in CSOM: Our Experience in Rural Population of South India. IOSR-JDMS. 2016;15(1):49-53.

Dhulipalla S, Choudary S, Madala N. A study to evaluate the role of High Resolution CT temporal bone in preoperative assessment of ossicular chain status in CSOM patients. IOSR J Dental Med Sci. 2018;17(1):33-7.

Mohammed A, Abdel R, Abdel K, Abdel G, Ahmed AE, Ahmed AS. 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.

Ghada A, Rania A, Ahmad A, Atef H. The Role of HRCT in evaluation of acquired middle ear cholesteatoma otitis prior to surgery. ZUMJ. 2015;21(5):449-61.