Computed tomography in chronic suppurative otitis media: value in surgical planning

Area of Science:

• Radiology
• Otolaryngology
• Medical Imaging

Background:

• Chronic suppurative otitis media (CSOM) often requires surgical intervention.
• Accurate preoperative assessment is crucial for successful surgical outcomes in CSOM.

Purpose of the Study:

• To prospectively evaluate the accuracy of high-resolution computed tomography (HRCT) in defining the extent and severity of CSOM.
• To assess HRCT's utility in converting surgical exploration into planned procedures.

Main Methods:

• Sixty adult patients with CSOM underwent HRCT by a single radiologist.
• Radiological findings were compared with surgical findings from mastoid exploration by a single otologist.
• Statistical comparison was performed between imaging and surgical data.

Main Results:

• HRCT accurately predicted the presence and distribution of soft tissue in the middle ear cleft and mastoid.
• Malleus and parts of the incus were well visualized; stapes suprastructure and long incus process were not.
• Lateral semicircular canal fistulae, facial nerve dehiscence, and tegmen tympani defects were detected with varying accuracy.

Conclusions:

• HRCT is a valuable tool for accurately imaging pathological anatomy in unsafe CSOM.
• Routine use of HRCT, especially in complicated cases, can enhance preoperative assessment and surgical outcomes.
• Increased experience and larger studies may further improve HRCT accuracy and justify its routine use.