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Role of CT Mastoids in the Diagnosis and Surgical Management of Chronic Inflammatory Ear Diseases

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Indian Journal of Otolaryngology and Head & Neck Surgery Aims and scope Submit manuscript

Abstract

Chronic Suppurative Otitis Media (CSOM) is a chronic inflammation of middle ear cleft. It presents with discharging ear and decreased hearing. The diagnosis is mostly on clinical examination with otoscope or oto endoscope. Computerised Tomography (CT) of mastoids is done to evaluate the extent of the disease and its complication. High resolution CT is now the investigation of choice for temporal bone disease. This study emphasizes on the importance of CT scan in diagnosis of inflammatory ear diseases and most importantly identifying pitfalls or complications which a surgeon can come across during surgery. The aims and objectives of this study is (1) to establish the efficacy of CT in the diagnosis of the complications and surgical management of chronic inflammatory pathologies of middle ear. (2) To find subgroups of CSOM where CT is particularly useful. In this series, a total of 25 cases presenting to our OPD at Govt. ENT Hospital between 2013 and 2014 have been diagnosed and findings of surgery correlated with HRCT scan of temporal bones done preoperatively. In this study, 64 % of the patients were male and incidence of CSOM with patients undergoing surgery belonged to the age group 21–30 years (32 %). The most common presenting symptom was ear discharge (92 %) and decreased hearing (96 %). The most common type of pathology in this study was attic perforation (36 %) and granulations (40 %) followed by cholesteatoma (36 %) and mucosal edema (16 %). Not all cases presented with complications, facial palsy (12 %) and mastoid abscess (8 %) were among few complications seen. 14 patients (56 %) of 25 cases underwent simple cortical mastoidectomy followed by 9 cases (36 %) for modified radical mastoidectomy and atticotomy for 2 cases (8 %). CT scan findings correlated well with surgical findings for cholesteatoma, middle ear mass and bone erosions. Where as for ossicular integrity and facial canal dehiscence, there was a discrepancy.

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References

  1. Browning GG, Merchant SN, Kelly G, Swan LRC, Canter R, McKerrow WS (2008) Chronic otitis media. In: Kerr AG (ed) Scott-Brown’s otolaryngology, chap 237c, 7th edn, vol 3. Arnold, London, pp 3395–3445

  2. Som PM, Curtin HD (2003) Head and neck imaging, 4th edn, vol 2. Mosby, St. Louis

  3. Drake R, Vogl AW, Mitchell AWM (2014) Gray’s Anatomy. Descriptive and applied anatomy of adult temporal bone. Elsevier, Churchill

  4. Ballantyne J (ed) (1978) Operative surgery—EAR, 3rd edn. Butterworth, London

  5. Shambaugh JR (1990) Surgery of the ear, surgical management of CSOM, 4th edn. WB Saunders and Co.

  6. Paparella MM, Kim CS (1977) Mastoidectomy update. Laryngoscope 1977(87):88

    Google Scholar 

  7. Vlastarakos PV, Kiprouli C, Pappas S, Xenelis J, Maragoudakis P, Troupis G et al (2012) CT scan versus surgery: how reliable is the pre-operative radiological assessment in patients with chronic otitis media. Eur Arch Otorhinolaryngol 269:81–86

    Article  PubMed  Google Scholar 

  8. Bluestone CD (1998) Epidemiology and pathogenesis of chronic suppurative otitis media: implications for prevention and treatment. Int J Pediatr Otorhinolaryngol 42:207

    Article  CAS  PubMed  Google Scholar 

  9. Kennedy K, Vrabec J, Quinn Jr. FB (1999) Cholesteatoma: pathogenesis and surgical management. Department of Otolaryngology, UTMB, Grand Rounds Presentation

  10. Sirigiri RR, Dwaraknath K (2011) Correlative study of HRCT in attico-antral disease. Indian J Otolaryngol Head Neck Surg 63:155–158

    Article  PubMed  PubMed Central  Google Scholar 

  11. Johnson DW, Voorhees RL, Lufkin RB, Hanafee W, Canalis R (1983) Cholesteatomas of the temporal bone: role of computed tomography. RSNA Radiol Soc N Am 148(3)

  12. Mafee MF, Levin BC, Applebaum EL, Campos M, James CF (1988) Cholesteatoma of the middle ear and mastoid A comparison of CT scan and operative findings. Otolaryngol Clin N Am 21:265–293

    CAS  Google Scholar 

  13. 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 Laryngol Otol 105:990–994

    Article  PubMed  Google Scholar 

  14. 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 

  15. Garber LZ, Dort JC (1994) Cholesteatoma: diagnosis and staging by CT scan. J Otolaryngol 23:121–124

    CAS  PubMed  Google Scholar 

  16. Rocher P, Carlier R, Attal P, Doyon D, Bobin S (1995) Contribution and role of the scanner in the pre-operative evaluation of chronic otitis. Radiosurgical correlation apropos of 85 cases. Ann Otolaryngol Chir Cervicofac 112:317–323

    CAS  PubMed  Google Scholar 

  17. Magliulo G, Colicchio MG, Appiani MC (2011) Facial nerve dehiscence and cholesteatoma. Ann Otol Rhinol Laryngol 120:261–267

    Article  PubMed  Google Scholar 

  18. Keskin S, Çetin H, Töre HG (2011) The correlation of temporal bone CT with surgery findings in evaluation of chronic inflammatory diseases of the middle ear. Eur J Gen Med 8:24–30

    Google Scholar 

  19. Trojanowska A, Drop A, Trojanowski P, Rosiñska Bogusiewicz K, Klatka J, Bobek-Billewicz B (2012) External and middle ear diseases: radiological diagnosis based on clinical signs and symptoms. Insights Imaging 3:33–48

    Article  PubMed  Google Scholar 

  20. Lemmerling MM, De Foer B, VandeVyver V, Vercruysse JP, Verstraete KL (2008) Imaging of the opacified middle ear. Eur J Radiol 66:363–371

    Article  CAS  PubMed  Google Scholar 

  21. Arangasamy A, Chandrasekaran K, Balakrishnan S (2012) Soft tissue attenuation in middle ear on HRCT. In: Mini—Symposia Head and Neck, vol 22, no. 4, pp 298–304

  22. Mahmood FM et al (1998) Direct sagittal CT in the evaluation of temporal bone disease. AJNR Am J Neuroradiol 9:371–378

    Google Scholar 

  23. Valvassori GE, Mafee MF (1985) The temporal bone. In: Carter BL (ed) Computed tomography of the head and neck. Churchill Livingstone, New York, p 171

    Google Scholar 

  24. Zonneveld FW (1983) The value of non-reconstructive multiplanar CT for the evaluation of the petrous bone. Neuroradiology 25:1–10

    Article  CAS  PubMed  Google Scholar 

  25. Zonneveld FW, Van Waes PFG, Damsma P, Rabischong P, Vignaud J (1983) Direct multiplanar computed tomography of the petrous bone. Radiographies 3:41

    Article  Google Scholar 

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Funding

This study is author’s independent work. No funds taken.

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Authors and Affiliations

  1. Govt. Medical College/Hospital, Nizamabad, Telangana, India

    Juveria Majeed & L. Sudarshan Reddy

  2. G-4, Jamuna Sadan, Mayuri Marg, Begumpet, Hyderabad, Telangana, 500016, India

    Juveria Majeed & L. Sudarshan Reddy

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  1. Juveria Majeed
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  2. L. Sudarshan Reddy
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Correspondence to L. Sudarshan Reddy.

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Animals were not involved in this study.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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

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Majeed, J., Sudarshan Reddy, L. Role of CT Mastoids in the Diagnosis and Surgical Management of Chronic Inflammatory Ear Diseases. Indian J Otolaryngol Head Neck Surg 69, 113–120 (2017). https://doi.org/10.1007/s12070-016-1023-z

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  • DOI: https://doi.org/10.1007/s12070-016-1023-z

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