Correlative Study of High-Resolution Computed Tomography Temporal Bone with Intraoperative Findings in Tympanomastoid Surgery

Abstract

Abstract Introduction: The global incidence of chronic otitis media (COM) is approximately 4.76 per thousand, with 31 million cases causing various complications. Most of these patients require one of the various forms of mastoid surgeries. High-resolution computed tomography (HRCT) has greatly improved the ability to assess both bony architecture and soft-tissue status. Aim: The aim is to assess the correlation of HRCT temporal bone with intraoperative findings in tympanomastoid surgery and to evaluate the sensitivity, specificity, positive predictive value, and negative predictive value of HRCT temporal bone. Materials and Methods: This prospective study was conducted in the Department of Otorhinolaryngology, SDM College of Medical Sciences and Hospital, Dharwad from November 2012–April 2014. Fifty patients of COM were taken up for study who underwent preoperative HRCT temporal bone followed by appropriate tympanomastoid surgery. Results: HRCT temporal bone showed increased sensitivity and specificity in detecting ossicular chain erosion and soft tissue abnormality within the middle ear and mastoid air cells. Facial nerve canal erosion was correctly detected in 62.50%, and overall agreement between surgical findings and the scan was high (90%). It also showed a very high specificity of 95.24%. For semicircular canal erosion and dural plate erosion, sensitivity was 50% each, specificity was 100% and had a very good correlation with surgical findings. Two cases of erosion of the posterior bony wall of the external auditory canal were correctly detected by the HRCT scan. Conclusion: HRCT temporal bone was found to have a high overall correlation with surgical findings and can be a useful method for early diagnosis of complications of COM and preoperative assessment.