Praxis of Otorhinolaryngology

Sensitivity, specificity and accuracy of computed tomography in patients with cholesteatoma

Elif Hocaoğlu1, Sema Aksoy1, Arda Kayhan2, Ömer Erdur3, Aylin Karahasanoğlu1, Tan Cimilli1

1Bakırköy Dr. Sadi Konuk Eğitim Ve Araştırma Hastanesi, Radyoloji Bölümü, Istanbul
2Namik Kemal Üniversitesi Tıp Fakültesi, Radyoloji Ana Bilim Dalı, Tekirdağ
3Bakırköy Dr. Sadi Konuk Eğitim Ve Araştırma Hastanesi, Kbb Bölümü, Istanbul

Keywords: Cholesteatoma, computed tomography, ear.

Abstract

OBJECTIVE: This study aims to investigate the sensitivity, specificity and accuracy rates of high-resolution computed tomography (HRCT) preoperatively in patients with cholesteatoma.

METHODS: Preoperative HRCT findings of the temporal bone and postoperative outcomes in 57 patients (32 males, 25 females; mean age 29 years; range 8 to 68 years) who were operated due to cholesteatoma in the middle ear were retrospectively analyzed. For the HRCT scan, consecutive axial sections in 1 mm thickness were taken and coronal reconstructions of these sections were created. A 120 KV, 180 MA, 512x512 matrix values and a bone filter were used. None of the patients received any intravenous contrast agent. All HRCT images were evaluated by two experienced radiologists by consensus. Preoperative HRCT findings and postoperative results were compared.

RESULTS: All patients were assessed in terms of the presence of soft tissue in the middle ear or mastoid cells, erosion or destruction of the scutum, tegmen or middle ear ossicles. Twenty-seven patients had pathology in right ear, while 30 patients had pathology in left ear. Of the patients, 100% and 96.5% had soft tissue in the middle ear and in the mastoid, respectively, as revealed by both HRCT and intraoperatively.

CONCLUSION: The HRCT provides detailed information on the choice of surgical technique and possible complications to the surgeon, in addition to the presence of middle ear cholesteatoma. Therefore, all patients with middle ear pathology who are scheduled for surgery should be evaluated carefully by preoperative HRCT.