Skip to main content
Log in

Revisiting Correlation Between Pre Operative High Resolution Computed Tomography and Operative Findings in Attico Antral Disease

  • Original Article
  • Published:
Indian Journal of Otolaryngology and Head & Neck Surgery Aims and scope Submit manuscript

Abstract

(1) To correlate the findings of high resolution computed tomography (HRCT) scans with operative findings in chronic otitis media (attico antral disease). (2) To assess the role of HRCT in chronic otitis media (attico antral disease). This prospective observational study undertaken at a tertiary level teaching hospital included 50 patients of chronic otitis media (attico antral disease) who underwent pre-operative HRCT scanning and the findings were compared with the operative findings and correlation between the two was assessed with appropriate statistical methods. HRCT findings correlated well for the status of malleus and incus, facial nerve canal, lateral semicircular canal, and sinus plate but were less accurate for stapes and tegmen plate. As for disease extent and prediction of cholesteatoma the degree of correlation was site dependent being greater in mastoid air cell system and epitympanum and lesser in mesotympanum and hypotympanum. HRCT despite of its value in management of chronic otitis media has its drawbacks and limitations. CT’s accuracy of prediction in some aspects of the disease varies with the site of pathology and this point must always be kept in mind by the operating surgeon. We suggest that each health care centre should establish their own correlative indices for HRCT temporal bone imaging in COM. HRCT cannot be entirely relied upon in management of chronic otitis media patients. However against the backdrop of improved radiological skills in interpreting temporal bone ct images, improved CT machines and importantly the growing concern over medicolegal issues, the role of pre operative CT scan in COM is much more than what was thought previously. Undoubtedly, it is a very useful ‘aid’ to management BUT a well-trained, experienced and alert surgeon is the key for an accurate diagnosis and successful management of chronic otitis media (attico-antral disease).

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Jackler RK, Dillon WP, Schindler RA (1984) Computed tomography in suppurative ear disease: a correlation of surgical and radiographic findings. Laryngoscope 94:746–752

    CAS  PubMed  Google Scholar 

  2. O’Reilly BJ, Chevretton EB, Wylie I, Thakkar C, Butler P, Sathanathan N et al (1991) The value of CT scanning in chronic suppurative otitis media. J LaryngolOtol 105:990–994

    Article  Google Scholar 

  3. Walshe P, McConn Walsh R, Brennan P, Walsh M (2002) The role of computed tomography in the preoperative assessment of chronic suppurative otitis media. Clin Otolaryngol Allied Sci 27:95–97

    Article  CAS  Google Scholar 

  4. Banerjee A, Flood LM, Yates P (2003) Computed tomography in suppurative ear disease: does it influence management? J Laryngol Otol 117:454–458

    Article  CAS  Google Scholar 

  5. Chatterjee P, Khanna S (2015) Role of high resolution computed tomography of mastoids. Indian J Otolaryngol Head Neck Surg 67(3):275–280. https://doi.org/10.1007/s12070-015-0873-0(in Planning Surgery for Chronic Suppurative Otitis Media)

    Article  PubMed  PubMed Central  Google Scholar 

  6. Gerami H, Naghavi E, WahabiMoghadam M, Forghanparast K, Akbar MH (2009) Comparison of preoperative computerized tomography scan imaging of temporal bone with the intraoperative findings in patients undergoing mastoidectomy. Saudi Med J 30:1048

    Google Scholar 

  7. Phelps PD, Wright A (1990) Imaging cholesteatoma. Clin Radiol 41:156–162

    Article  CAS  Google Scholar 

  8. Gaurano JL, Joharjy IA (2004) Middle ear cholesteatoma: characteristic CT findings in 64 patients. Ann Saudi Med 24:4427

    Article  Google Scholar 

  9. Sirigiri RR, Dwaraknath K (2011) Correlative study of HRCT in attico antral disease. Indian J Otolaryngol Head Neck Surg 63:1558

    Article  Google Scholar 

  10. Mafee ME, Levin BC, Applebaum EL, Campos M, James CE (1988) Cholesteatoma of the middle ear and mastoid. A comparison of CT and operative findings. Otolaryngol Clin N Am 24(2):265–293

    Google Scholar 

  11. Chee NW, Tan TY (2001) The value of preoperative high resolution CT scans in cholesteatoma surgery. Singap Med J 42:1559

    Google Scholar 

  12. Bates GJ, O’Donoghue GM, Anslow P, Houlding T (1988) Can CT Detect labyrinthine fistulae preoperatively? Ada Otolaryngol 106:40–45

    CAS  Google Scholar 

  13. Berry S, Gandotra SC, Saxena NC (1998) Role of computed tomography in unsafe chronic suppurative otitis media. Indian J Otolaryngol Head Neck Surg 50:1359

    Article  Google Scholar 

  14. Rai T (2014) Radiological study of the temporal bone in chronic otitis media: prospective study of 50 cases. Indian J Otol 20:48–55

    Article  Google Scholar 

  15. Vlastarakos PV, Kiprouli C, Pappas S, Xenelis J, Maragoudakis P, Troupis G et al (2012) CT scan versus surgery: how reliable is thepreoperative radiological assessment in patients with chronic otitis media? Eur Arch Otorhinolaryngol 269:816

    Google Scholar 

  16. Park MH, Rah YC, Kim YH, Kim JH (2011) Usefulness of computed tomography Hounsfield unit density in preoperative detection of cholesteatoma in mastoid ad antrum. Am J Otolaryngol 32:194–197

    Article  Google Scholar 

  17. Leighton SEJ, Robson AK, Anslow P et al (1993) The role of CT imaging in management of CSOM. Clin Otolaryngol 18:23–29

    Article  CAS  Google Scholar 

  18. Browning GG, Luxon LM (2008) The ear, hearing and balance. In: Gleeson M (ed) Scott-Brown’s otorhinolaryngology, head and neck surgery, 7th edn. Hodder Arnold, London, p 3395

    Chapter  Google Scholar 

  19. Cook JA, Krishnan S, Fagan PA (1996) Hearing results following modified radical versus canal-up mastoidectomy. Ann Otol Rhinol Laryngol 105(5):379–383

    Article  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Sabeeh Beig.

Ethics declarations

Conflicts of interest

The authors declare that they have no conflicts of interest.

Ethical approval

All procedures performed were in accordance with the ethical standards of the institutional ethics committee and with the 1964 helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

All participants were adequately informed about the procedure and an informed written consent was taken and the participants were then recruited for the study.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Beig, S., Sharma, S.C. & Khalid, M. Revisiting Correlation Between Pre Operative High Resolution Computed Tomography and Operative Findings in Attico Antral Disease. Indian J Otolaryngol Head Neck Surg 71 (Suppl 2), 1351–1356 (2019). https://doi.org/10.1007/s12070-018-1419-z

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12070-018-1419-z

Keywords

Navigation