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CC BY-NC-ND 4.0 · Int Arch Otorhinolaryngol 2022; 26(03): e414-e421
DOI: 10.1055/s-0041-1736580
Original Research

Are Hounsfield Unit Measurements of Bony Absorption Changes in Cholesteatoma Helpful?

Shay Shemesh 
1   Department of Otolaryngology-Head and Neck Surgery, Samson Assuta Ashdod University Hospital, Faculty of Health Sciences, Ben Gurion University, Ashdod, Israel
,
Judith Luckman
2   Department of Radiology, Assuta Medical Centers, Faculty of Health Sciences, Ben Gurion University, Tel Aviv, Israel
,
Tal Marom 
1   Department of Otolaryngology-Head and Neck Surgery, Samson Assuta Ashdod University Hospital, Faculty of Health Sciences, Ben Gurion University, Ashdod, Israel
,
Oded Kraus 
1   Department of Otolaryngology-Head and Neck Surgery, Samson Assuta Ashdod University Hospital, Faculty of Health Sciences, Ben Gurion University, Ashdod, Israel
,
Sharon Ovnat Tamir 
1   Department of Otolaryngology-Head and Neck Surgery, Samson Assuta Ashdod University Hospital, Faculty of Health Sciences, Ben Gurion University, Ashdod, Israel
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Abstract

Introduction High-resolution computed tomography (HRCT) scans of the temporal bone are used to assess the bony erosion of the middle-ear structures whenever cholesteatoma is suspected.

Objective To study the differences in HRCT Hounsfield unit (HU) index measurements of middle-ear bony structures between an ears with and without cholesteatoma.

Methods A retrospective study of 59 patients who underwent surgery due to unilateral cholesteatoma. The HRCT HU index of the scutum, of three middle-ear ossicles, of the lateral semicircular canal (LSCC), and of the fallopian canal was measured in both ears. A comparison was made between the cholesteatoma and the non-cholesteatomatous ear (control). All measurements were conducted by an otolaryngologist. To assess the interobserver bias, 10% of the samples were randomly and independently assessed by another otolaryngologist and a neuroradiologist who were blinded.

Results The average HU index was lower in the ear with cholesteatoma when compared with the non-cholesteatomatous ear. While the differences were statistically significant regarding the measurements of the scutum (516.02 ± 311.693 versus 855.64 ± 389.999; p = 0.001), the malleus (1049.44 ± 481.765 versus 1413.47 ± 313.376; p = 0.01), and the incus (498.03 ± 264.184 versus 714.25 ± 405.631; p = 0.001), the differences in the measurements of the LSCC (1042.34 ± 301.066 versus 1154.53 ± 359.609; p = 0.69) and of the fallopian canal (467.19 ± 221.556 versus 543.51 ± 263.573; p = 0.108) were not significantly different between both groups. The stapes was immeasurable in both groups due to its small size.

Conclusion Hounsfield unit index measurements are a useful tool that may aid in the diagnosis of early-stage cholesteatoma.

Keywords

computed tomography - Hounsfield unit - cholesteatoma - ossicles

Data Availability

The data that support the findings of the present study can be made available by the corresponding author upon reasonable request.


Compliance with Ethical Standards

1. Funding: the present research did not receive any specific grant from funding agencies in the public, private or not-for-profit sectors.


2. Ethical approval: the present study was approved by the Samson Assuta Ashdod University Hospital Institutional Review Board (under protocol number: 00034–18-AAA) and the Assuta Medical Centers Institutional Review Board (under protocol number: 0091–18-ASMC).




Publication History

Received: 03 July 2020

Accepted: 05 March 2021

Article published online:
11 November 2021

© 2021. Fundação Otorrinolaringologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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