Comparison of pre-operative temporal bone high resolution CT scan and intraoperative findings in patients with chronic suppurative otitis media

Abstract

Background and objectives:To compare the findings of high resolution computed tomography of temporal bone with intraoperative findings of patients suffering from chronic suppurative otitis media. Methods:This is a prospective randomize case study which was conducted on 100 patients complaining from chronic ear discharge and hearing impairment. The study was conducted at otolaryngology department, Rizgary Teaching hospital, Erbil City-Iraq from January 2016 to December 2018. The surgical procedures were the same for all patients as mastoid exploration. Based on the intraoperative finding it was decided either to choose canal wall up mastoidectomy or canal wall down mastoidectomy procedure that to be appropriate for particular case with studying and comparing the radiological finding accordingly. Results:Of the 100 patients,47% were males and 53% females. Eighteen cases were diagnosed with cholesteatoma and 82 cases were without. The high resolution computed tomography of temporal bone offered very high sensitivity in detecting erosion of scutum (100%), semicircular canal (100%), ossicles erosion (94%), but it gave low sensitivity 33% regarding prediction of facial nerve canal dehiscence. However, the prediction of the dehiscence of the facial canal should be not excluded regardless of images show intact facial canal in high resolution CT scan. Nearly 100% specificity obtained for erosion of scutum, semicircular canal, dehiscence of facial canal and sigmoid sinus wall. Whereas it is relatively less specific for erosion of ossicles and differentiation between the cholestatoma and granulation tissue. Conclusion:We concluded that high resolution computed tomography scan of temporal bone is a golden investigation before surgery for cases of chronic suppurative otitis media to plan for the type of surgery accordingly