High Resolution Computed Tomography of Temporal Bone: The Predictive Value in Atticoantral Disease
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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.
KeywordsAtticoantral 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.
All procedures involving human participants were in accordance with the ethical standards of the institution.
Informed consent was obtained from all individual participants included in the study.
- 2.Gulya AJ, Minor LB, Poe DS (eds) (2010) Glasscock-Shambaugh surgery of the ear, 6th edn. People’s Medical Publishing House, RaleighGoogle Scholar
- 3.Gleeson M, Browning GB, Clarke R (eds) (2008) Scott–Brown’s otolaryngology, head and neck surgery, 7th edn. Hodder Arnold, LondonGoogle Scholar
- 8.Karki S, Pokharel M, Suwal S, Poudel R (2017) Correlation between preoperative high resolution computed tomography (CT) findings with surgical findings in chronic otitis media (COM) squamosal type. Kathmandu Univ Med J 15(57):84–87Google Scholar
- 9.O’Donoghue GM (1987) Cholesteatoma: diagnosis and staging by CT scan. J Otolaryngol 12:157–160Google Scholar
- 10.Chee NW, Tan TY (2001) The value of preoperative high resolution CT scans in cholesteatoma surgery. Singap Med J 42(4):155–159Google Scholar
- 14.Prata AAS, Antunes ML et al (2011) Comparative study between radiological and surgical findings of chronic otitis media. Int Arch Otolaryngol 15(1):72–78Google Scholar