COMPARISON AND CORRELATION OF HIGH RESOLUTION COMPUTERIZED TOMOGRAPHY WITH CLINICAL AND INTRA-OPERATIVE FINDINGS IN CHOLESTEATOMA
Abdunnasar M. P.* Asif Iqbal K. and Santhi T.
ABSTRACT
Aim of the study: To study the correlation between high resolution computed tomography (HRCT) scan and intraoperative findings during surgery in cases of clinically diagnosed chronic otitis media with cholesteatoma. Materials and methods: This was a descriptive study conducted on 72 patients with acquired cholesteatoma at Govt TD Medical College, Alappuzha for a period of 18 months. All the patients were subjected to high resolution computed tomography scans. Radiological correlation was done with the intra-operative findings. Sensitivity, specificity, positive and negative predictive values were calculated. Histopathological findings were noted. Results: 24 (33.3%) patients had holotympanic cholesteatoma, 21 (29.2%) had involvement of the attic alone and 16 (22.2%) had attic and antrum involved.100% correlation was found with bony wall erosions, whereas 96.9% and 75% sensitivity were noted in incus and stapes erosions respectively. 100% specificity was obtained in facial canal and sinus plate erosion, while a specificity of 96.9% in tegmen erosion and 98% in were seen in malleus erosion. By chi square test the difference in correlation was not significant (p-value >0.01). Good correlation was seen for lateral semicircular canal fistula. Contrast CT is more specific, but MRI with diffusion weighted sequences is the best in imaging cholesteatoma, especially residual lesions. Conclusion:Good correlation was found between HRCT scan and intra-operative findings in cases of COM with cholesteatoma in relation to bony wall erosion of the surrounding structures. CT scan alone cannot differentiate soft tissue masses.
Keywords: cholesteatoma, computed tomography scan, correlation, sensitivity, specificity.
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