DOI: http://dx.doi.org/10.18203/issn.2454-5929.ijohns20195700

Radio-surgical correlation of chronic suppurative otitis media

Yogeesha B. S., Nagaraj Maradi, Ravi Shekhar, Rohini D. Urs

Abstract


Background: Chronic suppurative otitis media (CSOM) because of disease nature and location of vital structures like middle ear ossicles, facial nerve, and lateral semicircular canal poses clinical as well as radiological challenge in diagnosis, especially the squamosal variety. Hence this study to evaluate radio-surgical correlation in cases of CSOM.

Methods: We retrospectively analysed 92 case records who met the inclusion criteria. Their pre-operative high-resolution computed tomography (HRCT) temporal bone imaging was evaluated for erosion of the ossicular chain and the fallopian canal. This was correlated with the surgical findings noted intra-operatively. The appropriate statistical analysis was carried out. The radio-surgical correlation was evaluated by Cohen’s kappa value.  

Results: The kappa value for status of ossicular chain was 0.805 and 0.384 for status of fallopian canal. HRCT imaging had a positive predictive value and negative predictive value of 94.3% and 85.3% respectively, in detecting ossicular chain erosion. In detecting fallopian canal erosion, HRCT showed a sensitivity of 33.3%. Analysing the individual ossicles, we found kappa to be 0.266 for malleus, 0.463 for incus and 0.827 for stapes.

Conclusions: There was excellent radio-surgical correlation for ossicular chain erosion while it was poor for fallopian canal erosion. HRCT showed excellent radio-surgical correlation for stapes, moderate for incus and poor for malleus. In-spite of its shortcomings in differentiating cholesteatoma and non-cholesteatomatous pathologies of the middle ear cleft, HRCT imaging plays a key role in assessing the status of the ossicles and fallopian canal.

 


Keywords


Fallopian canal erosion, High resolution computerised tomography temporal bone, Ossicular erosion, Radio-surgical correlation

Full Text:

PDF

References


Biswas A. Pure tone audiometry. In: Biswas A (ed) Clinical audio-vestibulometry, 4th edn. Bhalani publishing house, Mumbai; 2009:5-16.

Majeed J, Reddy LS. Role of CT mastoids in the diagnosis and surgical managementof chronic inflammatory ear diseases. Indian J Otolaryngol Head Neck Surg. 2017;69(1):113-20.

Vaid S, Kamble Y, Vaid N, Bhatti S, Rawat S, Nanivadekar A, et al. Role of magnetic resonance imaging in cholesteatoma: the Indian experience. Indian journal of otolaryngology and head and neck surgery: official publication of the Association of Otolaryngologists of India, 2011;65(Suppl3):485-92.

Cohen J. A coefficient of agreement for nominal scales. Educ Psychol Meas. 1960;20:37-46.

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

Paparella MM, Kim CS. Mastoidectomy update. Laryngoscope.1977;87:88.

Sirigiri RR, Dwaraknath K. Correlative study of HRCT inattico-antral disease. Indian J Otolaryngol Head Neck Surg. 2011;63:155-8.

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.

Gül A, Akdağ M, Kiniş V, Yilmaz B, Şengül E, Teke M, et al. Radiologic and surgical findings in chronic suppurative otitis media. J Craniofac Surg. 2014;25(6):2027-9.

Jackler RK, Dillon WP, Schindler RA. Computed tomography in suppurative ear disease: A correlation of surgical and radiographic findings. The Laryngoscope. 1984;94:746-52.

Chee NW, Tan TY. The value of pre-operative high-resolution CT scans in cholesteatoma surgery. Singapore Med J. 2001;42(4):155-9.

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;26(74):7-12.

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.