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Utilizing temporal imaging to enhance early diagnosis of eosinophilic otitis media in clinical practice
Chenyu Chen1,2, Hongjing Wu3,4, Binjun Chen1,2
1ENT Institute and Department of Otorhinolaryngology, Eye & ENT Hospital, Fudan University, Shanghai, China.
Purpose:
The diagnosis of eosinophilic otitis media (EOM) remains a major challenge. Current diagnostic methods rely primarily on accurate samples of middle ear tissue or secretions, which can be complex. In this study, we sought to explore the diagnostic value of mastoid pneumatization combined with other temporal radiological features for EOM.
Methods:
This study included 28 patients with EOM and 32 patients with ordinary OM. All participants underwent the temporal bone HRCT, and middle ear status was assessed using four sections: mesotympanum, attic, antrum, and mastoid air cells. Quantification of negative temporal bone pressure using three-dimensional analysis of mastoid volume images.
Results:
The volumes of eosinophilic/non-eosinophilic mastoid air cells were approximately the same but were asymmetric. In contrast, in the normal OM group, there was a significant difference in the volume of mastoid air cells between the inflammatory and non-inflammatory sides. Statistically, the degree of opacification to the mesotympanum, attic, and mastoid air cells was more severe in patients with EOM than in patients with ordinary OM on the affected side. Furthermore, on the normal side, the opacification of the all four sites in the eosinophil group was basically worse than that in the control group.
Conclusion:
Eosinophilic individuals have been found to be specific to the mastoid air cell system and middle ear status and are important factors to consider. Therefore, the potential imaging information of HRCT can help otologists diagnose EOM earlier and provide timely and effective treatment.
Insights
Diagnosing eosinophilic otitis media (EOM) is challenging. High-resolution computed tomography (HRCT) of temporal bone features, like mastoid air cell opacification, may aid earlier EOM diagnosis and treatment.
Area of Science:
- Otolaryngology
- Radiology
- Medical Imaging
Background:
- Eosinophilic otitis media (EOM) diagnosis is difficult.
- Current methods require invasive sampling of middle ear tissue or secretions.
- Novel imaging biomarkers are needed for EOM diagnosis.
Purpose of the Study:
- To investigate the diagnostic utility of mastoid pneumatization and other temporal bone radiological features for EOM.
- To correlate HRCT findings with EOM presence and severity.
Main Methods:
- Retrospective study of 28 EOM patients and 32 ordinary otitis media (OM) patients.
- High-resolution computed tomography (HRCT) of the temporal bone was performed.
- Mastoid air cell volume and middle ear opacification were quantified using 3D analysis.
Main Results:
- Mastoid air cell volumes were asymmetric in EOM but symmetric in ordinary OM.
- Opacification of the mesotympanum, attic, and mastoid air cells was more severe in EOM patients.
- Opacification was worse on the affected and normal sides in the eosinophilic group compared to controls.
Conclusions:
- Mastoid air cell system and middle ear status on HRCT are specific indicators for EOM.
- HRCT imaging provides valuable information for early EOM diagnosis.
- Timely diagnosis via HRCT can lead to effective treatment of EOM.
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