EVALUATION OF CHRONIC SUPPURATIVE OTITIS MEDIA BY HIGH RESOLUTION COMPUTED TOMOGRAPHY OF TEMPORAL BONE A STUDY OF 50 PATIENTS

DR. PANKAJ KUMAR YADAV; DR. RUCHI VAISHY

Volume : VII, Issue : V, May - 2018

EVALUATION OF CHRONIC SUPPURATIVE OTITIS MEDIA BY HIGH RESOLUTION COMPUTED TOMOGRAPHY OF TEMPORAL BONE A STUDY OF 50 PATIENTS

Dr. Pankaj Kumar Yadav, Dr. Ruchi Vaishy

Abstract :

The present study was conducted from May 2016 to Sept 2017 in Dept of Radiodiagnosis GRMC Gwalior. In this study total 50 patients of CSOM were selected .The purpose was tostudy the role, value and impact of high resolution computerized tomography in detecting ,evaluating and diagnosis of chronic suppurative otitis media

A total number of 50 patients with CSOM were selected. The age of patients range from 4 yrs to 55 yrs with maximum patients was falling between 11–20 yrs (46%).In our study the overall sex distribution showed female predominance . Male :female ratio was 0.8: 1 with males being 23 and female being 27 in number .X ray mastoid and HRCT temporal bone was done in every patient. Key feature to be considered are soft tissue mass in both safe and unsafe CSOM and non dependent soft tissue mass in patient with cholesteatoma, scutum and ossicular erosion, labyrinthine fistula, sigmoid sinus plate erosion, mastoid cortex erosion, tegmen erosion, and mastoiditis,the integrity or erosion of dural plate, sinus plate, lateral semicircular canal and lateral cortical wall. The erosion of ear ossicles – malleus and incus and stapes. In our study there are 50 patients ,among them 23 patients had tubotympanic{ SAFE TYPE} and 27 patients had atticoantral{ UN SAFE TYPE} disease or cholesteatoma on intraoperative confirmation .But HRCT diagnosis of cholesteatoma was made in 29 patients and in 21 patients with safe CSOM. , HRCT finding of cholesteatoma was found in 18 patient with 90.9% sensitivity and 100 % specificity . In our study ,HRCT had 90.7% sensitivity and 100 % specificity in detecting cholesteatoma in epitympanum, in mesotympanum 92.80% sensitive and 97.3 % specific , in cases of antrum it is 94.1% sensitive and 94.2 % specific ,for aditus85% sensitivity and 100 % specificity .For mastoid pnematization, scutum erosion and cochlear erosion HRCT is 100% sensitive and specific . 94.7% sensitive malleus erosion and 92% sensitive for incus erosion but 100% specific, 33.33% sensitive but 100% specific for facial canal dehiscence, sensitivity and specificity of HRCT to detect the tegmen tympani erosion was found to 100% and 97.9% , 100% sensitive in detecting cortical erosion of mastoid.Xray is found to be 100% sensitive and specific for mastoid pneumatisation.

HRCT scans of the temporal bone have significantly enhanced the preoperatively evaluation of CSOM .This study has shown that the CT imaging for CSOM accurately depicts soft tissue mass .