Comparison of preoperative computerized tomography scan imaging of temporal bone with the intra-operative findings in patients undergoing mastoidectomy

OBJECTIVE: To compare the consistency rates of pre- and intra-operative radiological findings in patients with chronic suppurative otitis media CSOM.

METHODS: In a cross-sectional study, 80 patients with CSOM underwent pre-operative CT scanning and we compared the results with intra-operative clinical findings during mastoidectomy from 2000-2004 in the Otology Department, Amiralmomenin Hospital of Guilan Medical University, Rasht, Iran. Sensitivity, specificity, positive and negative predictive value of CT scan in tympanic and mastoid cholesteatoma, ossicular chain erosion, tegmen tympani erosion, dehiscence of facial canal, lateral semicircular canal LSCC fistula were assessed. Then, correlation between radiological findings and intra-operative findings were calculated.

RESULTS: The mean age of the patients was 27.9 ± 16.3 years. Mostly were males n=57 [71.3%]. Correlation of preoperative radiological images with intra-operative clinical findings were moderate to good on tympanic cholesteatoma, mastoid cholesteatoma and ossicular chain erosion, but weak and insignificant in cases of tegmen tympani erosion, facial canal dehiscence and LSCC fistulae.

CONCLUSION: Preoperative CT scan may be helpful in decision-making for surgery in cases of cholesteatoma and ossicular erosion. Despite of limitations radiological scanning is a useful adjunct to management of CSOM.