Comparison of Preoperative Temporal Bone High-Resolution CT with Intraoperative Findings in Patients with Cholesteatoma

Abstract

Objective: To evaluate the use of a preoperative HRCT temporal bone for determining the amount and involvement of neighboring tissues by Cholesteatoma.

Methodology: This cross sectional validation study was conducted at the department of Radiology, Pakistan Institute of Medical Sciences, Islamabad, Pakistan, from 1st July 2023 to 31st December 2023. The study pertains 40 suspected patients of middle ear cholesteatoma, included through consecutive sampling. The preoperative examination was bilateral temporal bone HRCT imaging, followed by intraoperative findings. For statistical significance, both findings were compared. Severity of the disease was also assessed through disease severity assessment index. SPSS v25 software was used for statistical analysis. P-value <0.05 was considered significant.

Results: The average age of 40 cases of cholesteatoma was 36.73±18.22 years. The male to female ratio in the study was 2:3. We observed 16 different findings in our study and the results showed that HRCT results are associated with intraoperative findings against all structures with p value 0.000. The sensitivity specificity analysis showed that HRCT gives an unconfirmed results with a very low sensitivity for detecting facial canal erosion, tegmen erosion, LSCC erosion and sinus tympani and facial recess involvement.

Conclusion: HRCT temporal bone scan clearly demarcates soft tissue density in the middle ear and mastoid with surrounding bone erosions, as well as anatomical differences. We concluded that HRCT is a helping tool for detecting the involvement of neighboring tissues by cholesteatoma.