Evaluation of Temporal Bone Cholesteatoma and the Correlation between High-Resolution Computed Tomography and Surgical Findings

Aims and Objectives To study the role of HRCT in the preoperative evaluation of patients with cholesteatoma

Materials and Methods For the purpose of this study, a total of 60 patients attending outpatient department (OPD) and clinically diagnosed as squamosal type of chronic otitis media were included in the study. All the patients underwent a detailed history taking and clinical ENT examination. All otoscopic findings were confirmed by otomicroscopy. A preoperative HRCT of the temporal bone was done, using 128 slice GE CT scanner (VCT GE) in all the 60 patients. The selected patients then underwent tympanomastoidectomy via post aural route both under local and general anesthesia. Intraoperative findings were noted and preoperative HRCT findings were confirmed and compared with the intraoperative surgical findings.

Result Based on the findings, the present study concludes that preoperative HRCT has an excellent correlation with the intraoperative findings in detecting the location and extension of soft tissue and bony erosions for most of the structure except facial canal erosion and stapes where sensitivity was found to be low. Also, in this study, HRCT could not differentiate cholesteatoma from other pathology.

Conclusion The early identification of soft tissue and subtle bony erosions on HRCT helps the surgeon in planning the appropriate management and preventing impending complications.

Clinical Significance HRCT also serves as a tool in guiding the surgeon during surgery by giving prior information about the extent of the disease and associated bony erosions. Thus, HRCT of the temporal bone, as a preoperative investigation modality, is invaluable in the diagnosis and management of cholesteatoma.