Journal article
High-resolution computed tomography (HRCT) in pediatric and adult patients with unsafe chronic suppurative otitis media (CSOM) and its surgical correlation
Journal of family medicine and primary care, Vol.9(8), pp.4067-4073
08/01/2020
DOI: 10.4103/jfmpc.jfmpc_455_20
PMCID: PMC7586635
PMID: 33110811
Abstract
Background and Aim: Atticoantral, alias unsafe type of CSOM affects the posterosuperior part of the middle ear cleft and is frequently coupled with complications and bony erosions. This study aimed to correlate the high-resolution computed tomography (HRCT) temporal bone and intraoperative findings in the patients with the unsafe type of CSOM. Methods: This prospective study included 50 patients (28 males: 22 females; mean age 24 +/- 14 years) who presented with clinically suspected unsafe CSOM. All patients underwent HRCT of the temporal bone and subsequent surgical procedure. The intraoperative and histopathological findings were compared with HRCT findings. Descriptive statistics, sensitivity, specificity, and positive and negative predictive value for HRCT were calculated. Student's t-test and Chi-square test were performed. Results: Out of 50 patients, left, right, and bilateral ear involvement were seen in 42% (21/50), 38% (19/50), and 20% (10/50) patients, respectively. Ear discharge was the most common symptom (100%) followed by earache (66%), vertigo (16%), and tinnitus (14%), respectively. Cholesteatoma was reported in 82% (49/60) of ears on HRCT while histopathological and intraoperative evaluation confirmed the diagnosis in 40 out of 49 ears. In 18% (11/60) ears, the cholesteatoma was not diagnosed on HRCT evaluation; however, the intraoperative and histopathological assessment revealed cholesteatoma in six patients while the rest had granulation tissue. For detection of ossicular erosions, tegmen erosions, erosions of facial nerve canal, erosions of sigmoid sinus plate, and erosions of lateral/posterior semicircular canals; HRCT had high sensitivity (86.44%-100%) and specificity (93.33%-100%). Conclusion: HRCT has a superb correlation with intraoperative findings and is a valuable tool for preoperative assessment of temporal bone pathologies.
Details
- Title: Subtitle
- High-resolution computed tomography (HRCT) in pediatric and adult patients with unsafe chronic suppurative otitis media (CSOM) and its surgical correlation
- Creators
- Ramandeep Singh - Massachusetts General HospitalRubal Rai - Govt Med Coll & Hosp, Dept Anesthesia, Sect 32, Chandigarh, IndiaParamdeep Singh - Government Medical College and HospitalSanjay Sethi - University of CalgaryAmrit Pal Singh Ahluwalia - Government Medical CollegeGagandeep Choudhary - University of Alabama at Birmingham
- Resource Type
- Journal article
- Publication Details
- Journal of family medicine and primary care, Vol.9(8), pp.4067-4073
- Publisher
- Wolters Kluwer Medknow Publications
- DOI
- 10.4103/jfmpc.jfmpc_455_20
- PMID
- 33110811
- PMCID
- PMC7586635
- ISSN
- 2249-4863
- eISSN
- 2278-7135
- Number of pages
- 7
- Language
- English
- Date published
- 08/01/2020
- Academic Unit
- Radiology
- Record Identifier
- 9984700246702771
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