Clinical medicine insights. Ear, nose and throat · 2019
The Correlation Between Preoperative Findings of High-Resolution Computed Tomography (HRCT) and Intraoperative Findings of Chronic Otitis Media (COM).
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Aljehani Mariam, Alhussini Rayan
Аннотация
OBJECTIVES: The aim of this study was to investigate the correlation between the preoperative findings of high-resolution computed tomography (HRCT) of temporal bone in chronic otitis media (COM) and the intraoperative findings.
METHODS: This retrospective study was conducted in the ORL-HNS Unit at Ohud Hospital, Medina, Saudi Arabia, during the period from January to September 2018. We included all patients with COM, and an informed consent was obtained from all participants. The HRCT images were studied in comparison with the intraoperative findings. The parameters of comparison were tympanic membrane, middle ear structures, and the status of cholesteatoma.
RESULTS: A total of 39 patients were included in the analysis: 14 male and 25 female patients. The age range was 9 to 50 years. As a result of the comparison between HRCT findings and intraoperative observations, we found that incus erosion through computed tomography (CT) was the same as during surgical observation in 12 cases (30.8%). Malleus appeared eroded on CT in 1 case (2.6%); however, 5 cases were seen with that observation during operation (12.8%). Cholesteatoma was similarly seen in the CT scan and during surgery with a significant relation between intraoperative cholesteatoma extending and HRCT findings of the disease (95% confidence level, P-value = 0.001). The sensitivity, specificity, positive predictive value, and negative predictive value were 100% for detecting sigmoid plate erosion, dura exposure, incus erosion, stapes erosion, and malleus-incus joint discontinuity through preoperative CT.
CONCLUSIONS: Intraoperative findings and HRCT have shown better results with good correlation of diagnostic value regarding the comparisons between recorded observations, especially in detecting sigmoidal plate erosion, dural exposure, incus and stapes erosion, and malleus-incus joint discontinuity. Preoperative CT scan is beneficial and contributory in the decision of indicating surgery to patients.
METHODS: This retrospective study was conducted in the ORL-HNS Unit at Ohud Hospital, Medina, Saudi Arabia, during the period from January to September 2018. We included all patients with COM, and an informed consent was obtained from all participants. The HRCT images were studied in comparison with the intraoperative findings. The parameters of comparison were tympanic membrane, middle ear structures, and the status of cholesteatoma.
RESULTS: A total of 39 patients were included in the analysis: 14 male and 25 female patients. The age range was 9 to 50 years. As a result of the comparison between HRCT findings and intraoperative observations, we found that incus erosion through computed tomography (CT) was the same as during surgical observation in 12 cases (30.8%). Malleus appeared eroded on CT in 1 case (2.6%); however, 5 cases were seen with that observation during operation (12.8%). Cholesteatoma was similarly seen in the CT scan and during surgery with a significant relation between intraoperative cholesteatoma extending and HRCT findings of the disease (95% confidence level, P-value = 0.001). The sensitivity, specificity, positive predictive value, and negative predictive value were 100% for detecting sigmoid plate erosion, dura exposure, incus erosion, stapes erosion, and malleus-incus joint discontinuity through preoperative CT.
CONCLUSIONS: Intraoperative findings and HRCT have shown better results with good correlation of diagnostic value regarding the comparisons between recorded observations, especially in detecting sigmoidal plate erosion, dural exposure, incus and stapes erosion, and malleus-incus joint discontinuity. Preoperative CT scan is beneficial and contributory in the decision of indicating surgery to patients.