Применение компьютерной томографии височных костей в планировании и оценке эффективности реконструктивной хирургии среднего уха

Abstract

One of the possible methods of eliminating the trephine defect after performing open-type operations on the middle ear in patients with suppurative otitis media is obliteration of the cavities of the middle ear with fat tissue. There are no references to radiological assessment of emerging changes when using this technique in the domestic and foreign literature, which dictates the need to develop predictors of negative results in the early postoperative period. We have studied the possibility of using computed tomography (CT) of the temporal bones to evaluate a fat implant in order to predict the outcome of reconstructive intervention during obliteration of the retrotympanic parts of the middle ear with fat tissue. All patients underwent control CT examinations 1, 3, 6, and 12 months after surgery. Depending on the clinical manifestations in the postoperative period, the examined patients were divided into three groups. As a result of the study, the analysis of the CT picture showed that an increase in the density characteristics of the autograft and the appearance of small gas bubbles in the early postoperative period are not a predictor of the negative result of the surgery. Whereas the CT picture of the presence of a large amount of gas and, as a consequence, the absence of a well-formed fat sac already in the early postoperative period were harbingers of the negative outcome of the surgery. Thus, obliteration of the middle ear cavity by auto-fat is a reliable method of treatment of chronic purulent otitis media; therefore, further integration of this technique into clinical practice with the use of CT of temporal bones is planned.