High Resolution Computed Tomography of Temporal Bone: The Predictive Value in Atticoantral Disease

  • Shantanu Mandal
  • K. Muneer
  • Manaswita RoyEmail author
Original Article


To evaluate predictive value of high resolution computed tomography in atticoantral disease. We conducted a prospective observational study in 49 patients suffering from atticoantral disease at tertiary referral institute. Preoperatively, all the patients underwent unenhanced high resolution computed tomography (HRCT) of temporal bone parallel to orbitomeatal line by using multislice scanner. We evaluated presence of soft tissue attenuation, ossicular erosion, facial canal erosion, dural exposure, erosion of semicircular canal, labyrinthine fistula, erosion of scutum and tegmen tympani in CT scan. HRCT is recommended in atticoantral disease with complications. This study demonstrates the predictive value of HRCT of temporal bone as a diagnostic modality in atticoantral disease. HRCT shows 100% sensitivity (Sn) of soft tissue density detected in middle ear, aditus and attic. Specificity (Sp) was more for eustechian tube area and sinus tympani. Ossicular erosions of malleus (Sn = 90.9%, Sp = 75%), incus (Sn = 93.2%, Sp = 80%), stapes (Sn = 78.8%, Sp = 68.8%) were detected. Erosion of scutum (Sn = 94.1%, Sp = 80%), tegmen (Sn = 66.7%, Sp = 100%), sinus plate (Sn = 100%, Sp = 97.9%), facial nerve canal (Sn = 75%, Sp = 100%), semicircular canal fistula (Sn = 80%, Sp = 97.7%) and cochlear promontory fistula (Sn = 50%, Sp = 97.9%) were evaluated. HRCT temporal bone helps to evaluate disease extent and involvement of surrounding structures. Hence it helps in deciding surgical approach and also prevents impending complications.


Atticoantral disease Middle ear cleft High resolution computed tomography 


Compliance with Ethical Standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical Approval

All procedures involving human participants were in accordance with the ethical standards of the institution.

Informed Consent

Informed consent was obtained from all individual participants included in the study.

Supplementary material

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Copyright information

© Association of Otolaryngologists of India 2018

Authors and Affiliations

  1. 1.Department of OtorhinolaryngologyVardhman Mahavir Medical College and Safdarjung HospitalNew DelhiIndia
  2. 2.Department of OtorhinolaryngologyMaanu Memorial Hospital MajeriMelakkam, MalappuramIndia

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