Abstract
To correlate the pre-operative Temporal Bone High Resolution Computer Tomography (HRCT) Scan findings with intraoperative findings in Chronic Otitis Media—Squamous type. This prospective, correlative, observational study was done at Department of Otorhinolaryngology and Head and Neck Surgery, Tribhuvan University Teaching Hospital, Kathmandu. 156 patients underwent mastoid surgery under General Anaesthesia from October 2017 to November 2018. Ethical committee approval taken from the institutional review committee. Informed consent regarding the study was taken prior to surgery. The peroperative findings were correlated with preoperative HRCT findings. Cohen’s kappa coefficient (k-value) was used to estimate the degree of correlation. Statistical analysis was done using SPSS version 25. Total 156 patients between 8 and 70 years of age were enrolled in the study. Presence of cholesteatoma/granulation on HRCT scan was found with 100% sensitivity with k-value of 0.569 denoting fair agreement. Regarding ossicular status, malleus showed maximum k-value of 0.525 with sensitivity of 81.3% followed by stapes and incus with k-value of 0.308 and 0.380 and sensitivity of 68.3% and 70.2% respectively. Sinus plate status showed perfect radiosurgical agreement with k-value of 1.0 and sensitivity and specificity of 100%. Bony facial canal demonstrated slight agreement with k-value of 0.506 and sensitivity of 45.8%. Dural plate status showed fair agreement with k-value of 0.503 and sensitivity of 38.9%. For Lateral Semicircular Canal (LSCC) erosion, we found very good agreement with k-value of 0.893 with sensitivity of 90.9%. Preoperative HRCT scan temporal bone correlates well for the detection of disease presence and shows good radiosurgical agreement for sinus plate erosion, LSCC erosion but fair agreement for dural plate erosion and malleus erosion. Plain HRCT scan with 3-D reconstruction is a poor predictor of bony facial canal, incus and stapes erosion.
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References
Acuin J, Organization WH (2004) Chronic suppurative otitis media: burden of illness and management options
Olszewska E, Wagner M, Bernal-Sprekelsen M, Ebmeyer J, Dazert S, Hildmann H et al (2004) Etiopathogenesis of cholesteatoma. European archives of oto-rhino-laryngology: official journal of the European Federation of Oto- Rhino-Laryngological Societies. 261(1):6–24
Goycoolea MV, Hueb MM, Ruah C (1991) Otitis media: the pathogenesis approach: Definitions and terminology. Otolaryngol Clin North Am 24(4):757–761
Gulya AJ, Minor LB, Glasscock ME, Poe D (2010) Glasscock-Shambaugh Surgery of the ear: PMPH-USA
Mafee MF, Valvassori GE, Dobben GD (1982) The role of radiology in surgery of the ear and skull base. Otolaryngol Clin North Am 15(4):723
Mafee MF, Singleton EL, Valvassori GE, Espinosa GA, Kumar A, Aimi K (1985) Acute otomastoiditis and its complications: role of CT. Radiology 155(2):391–397
Mafee M (1993) MRI and CT in the evaluation of acquired and congenital cholesteatomas of the temporal bone. The Journal of otolaryngology. 22(4):239–248
Mafee MF, Valvassori GE (2009) Imaging of the temporal bone. Ballenger’s Otolaryngol Head Neck Surg 17:145–171
Cundiff JG, Djalilian HR, Mafee MF (2006) Bilateral sequential petrous apicitis secondary to an anaerobic bacterium. Otolaryngol Head Neck Surg 135(6):969–971
Mafee M, Kumar A, Heffner D (1994) Epidermoid cyst (cholesteatoma) and cholesterol granuloma of the temporal bone and epidermoid cysts affecting the brain. Neuroimaging Clin N Am 4(3):561–578
Bathla M, Doshi H, Kansara A (2018) Is Routine Use of High Resolution Computerized Tomography of Temporal Bone in Patients of Atticoantral Chronic Suppurative Otitis Media without Intracranial Complications Justified? Indian J Otolaryngol Head Neck Surg 70(1):79–86
Kveton J (2010) Open cavity mastoid operations. Glasscock-Shambangh Surgery of the Ear 5th ed Hamilton, Ont, pp 499–516
Haaga JR, Boll DT (2016) CT and MRI of the whole body. Elsevier, Amsterdam
Casselman JW, Offeciers EF, De Foer B, Govaerts P, Kuhweide R, Somers T (2001) CT and MR imaging of congential abnormalities of the inner ear and internal auditory canal. Eur J Radiol 40(2):94–104
Walshe P, McConn Walsh R, Brennan P, Walsh M (2002) The role of computerized tomography in the preoperative assessment of chronic suppurative otitis media. Clin Otolaryngol Allied Sci 27(2):95–97
Dawson B, Trapp RG (2004) Basic & clinical biostatistics, 4th edn. McGraw-Hill Education, New York
Mahmutoglu AS, Celebi I, Sahinoglu S, Cakmakci E, Sozen E (2013) Reliability of preoperative multidetector computed tomography scan in patients with chronic otitis media. J Craniofac Surg 24(4):1472–1476
Rogha M, Hashemi SM, Mokhtarinejad F, Eshaghian A, Dadgostar A (2014) Comparison of preoperative temporal bone CT with intraoperative findings in patients with cholesteatoma. Iran J Otorhinolaryngol 26(74):7
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):84–87
Gupta R, Kanotra S, Gupta N, Sharma R, Gupta S, Kotwal S (2015) Correlation of high-resolution computed tomography temporal bone findings with intra-operative findings in patients with cholesteatoma. Indian J Otol 21(4):280
Gomaa MA, Abdel Karim AR, Abdel Ghany HS, Elhiny AA, Sadek AA (2013) Evaluation of temporal bone cholesteatoma and the correlation between high resolution computed tomography and surgical finding. Clin Med Insights Ear Nose Throat 6:21–28
Majeed J, Sudarshan Reddy L (2017) Role of CT mastoids in the diagnosis and surgical management of chronic inflammatory ear diseases. Indian J Otolaryngol Head Neck Surgery 69(1):113–120
Chatterjee P, Khanna S, Talukdar R (2015) Role of high resolution computed tomography of mastoids in planning surgery for chronic suppurative otitis media. Indian J Otolaryngol Head Neck Surg 67(3):275–280
Alzoubi FQ, Odat HA, Al-Balas HA, Saeed SR (2009) The role of preoperative CT scan in patients with chronic otitis media. Eur Arch Oto-Rhino-Laryngology 266(6):807–809
Gerami H, Naghavi E, Wahabi-Moghadam M, Forghanparast K, Akbar MH (2009) Comparison of preoperative computerized tomography scan imaging of temporal bone with the intra-operative findings in patients undergoing mastoidectomy. Saudi Med J 30(1):104–108
Ng JH, Zhang EZ, Soon SR, Tan VY, Tan TY, Mok PK et al (2014) Pre-operative high resolution computed tomography scans for cholesteatoma: has anything changed? Am J Otolaryngol 35(4):508–513
Payal G, Pranjal K, Gul M, Mittal MK, Rai AK (2012) Computed tomography in chronic suppurative otitis media: value in surgical planning. Indian J Otolaryngol Head Neck Surg 64(3):225–229
Sirigiri RR, Dwaraknath K (2011) Correlative study of HRCT in attico-antral disease. Indian J Otolaryngol Head Neck Surg 63(2):155–158
Bhalla AS, Singh A, Jana M (2017) Chronically discharging ears: evalution with high resolution computed tomography. Polish J Radiol 82:478–489
Vlastarakos PV, Kiprouli C, Pappas S, Xenelis J, Maragoudakis P, Troupis G et al (2012) CT scan versus surgery: how reliable is the preoperative radiological assessment in patients with chronic otitis media? Eur Arch Oto-Rhino-Laryngol 269(1):81–86
Karatag O, Guclu O, Kosar S, Derekoy FS (2014) Tegmen height: preoperative value of CT on preventing dural complications in chronic otitis media surgery. Clin Imaging 38(3):246–248
Kuo C-L, Shiao A-S, Yung M, Sakagami M, Sudhoff H, Wang C-H et al (2015) Updates and knowledge gaps in cholesteatoma research. Biomed Res Int 2015:17
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Agarwal, R., Pradhananga, R., Das Dutta, H. et al. Correlation of Pre-operative Temporal Bone CT Scan Findings with Intraoperative Findings in Chronic Otitis Media: Squamous Type. Indian J Otolaryngol Head Neck Surg 74 (Suppl 1), 33–42 (2022). https://doi.org/10.1007/s12070-020-01805-0
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DOI: https://doi.org/10.1007/s12070-020-01805-0