Diagnostic Accuracy of High-resolution Computed Tomography (HRCT) Temporal Bone in the Evaluation of Chronic Suppurative Otitis Media

Abstract

Chronic suppurative otitis media is a disease presented with recurrent purulent discharge through perforated tympanic membrane. Other clinical presentation varies form variable hearing loss, tinnitus, vertigo according to extent and complication of disease. Cholesteatoma is most common association of CSOM, and is characterized by presence of keratin and other desquamated tissue covered by squamous epithelium. Diagnosis of CSOM is readily made by otorhinolaryngologist with otoscopy or oto-endoscopy, though extent of disease can be evaluated through HRCT temporal bone or MRI of middle and inner ear. HRCT temporal bone is now widely acceptable as investigation of choice for evaluation of CSOM as it has high efficacy to detect bony erosion. The present study is conducted over 73 patients in the department of radiodiagnosis, Dr. S.N. medical college, Jodhpur, Rajasthan over a period between 2020 to 2021 with the aim to evaluate the diagnostic efficacy of HRCT temporal bone to identify presence and extension of disease, alteration of mastoid aeration, bony and ossicular erosion with the comparison of intraoperative findings in the form of sensitivity, specificity, positive and negative predictive value. In this study 44 patients(60%) were male, mean age of presentation is 30.52 ± 9.70 years. Common clinical presentation was ear discharge (91.8%) and hard of hearing(64%). presence of soft tissue density is most consistent finding present in 71(97.3%) patients, alteration of aeration of mastoid is observed in 67 (91.8%) patients, erosion of incus in frequent followed by maleus and stapes. Facial canal and lateral semicircular canal erosion is less common observation. The study concluded that HRCT temporal bone is reliable and evidentiary diagnostic tool in identifying the presence of disease, ossicular erosion, and detecting complication following CSOM.
 Keywords: Cholesteatoma, Ossicular erosion, Facial canal dehiscence, Lateral semicircular canal dehiscence