Correlation between high-resolution computed tomography temporal bone findings and surgical findings in patients with inflammatory diseases of the middle ear

Abstract

Background: With the advent of high-resolution computed tomography (HRCT), more information can be obtained about the anatomy of the middle ear, soft tissue pathologies, and the complications of middle ear disease process as compared to the conventional diagnostic methods. Aims: This study aims to study the spectrum of HRCT temporal bone findings in inflammatory middle ear diseases as well as correlate computed tomography (CT) with intraoperative findings. Settings and Design: This is a cross-sectional study including all consecutive patients presenting to the ear, nose, and throat department with a provisional diagnosis of inflammatory middle ear disease requiring surgical management and referred to department of radiodiagnosis for HRCT temporal bone. Materials and Methods: The HRCT findings of 58 such patients were compared with the intraoperative findings. Statistical Analysis Used: Interrater agreement Kappa was used to find agreement between CT and surgical findings. Diagnostic test was used to find out sensitivity, specificity, negative predictive value, and positive predictive value of CT taking surgery as gold standard. P < 0.05 was considered as statistically significant. Results: HRCT had high sensitivity for delineating the disease at most of the sites except for the facial canal and integrity of stapes. Correlative accuracy was highest in the region of the incus, labyrinth, scutum, sinus plate, inner ear, and jugular bulb. Conclusions: Our study showed moderate to very good correlation between HRCT temporal bone and operative findings. It also allowed early identification of complications enabling a better surgical approach and treatment plan.

Keywords

• Cholesteatoma
• high-resolution computed tomography
• inflammatory middle ear diseases