Hostname: page-component-cd9895bd7-hc48f Total loading time: 0 Render date: 2024-12-27T22:24:37.640Z Has data issue: false hasContentIssue false

Interpreting pre-operative mastoid computed tomography images: comparison between operating surgeon, radiologist and operative findings

Published online by Cambridge University Press:  08 January 2016

K Badran*
Affiliation:
Deparment of ENT, Monklands Hospital, Airdrie, Scotland, UK
S Ansari
Affiliation:
Deparment of ENT, Monklands Hospital, Airdrie, Scotland, UK
R Al Sam
Affiliation:
Deparment of Radiology, Monklands Hospital, Airdrie, Scotland, UK
Y Al Husami
Affiliation:
Deparment of Radiology, Monklands Hospital, Airdrie, Scotland, UK
A Iyer
Affiliation:
Deparment of ENT, Monklands Hospital, Airdrie, Scotland, UK
*
Address for correspondence: Mr K Badran, 66 Balforn Drive, Coatbridge ML5 4FF, Scotland, UK E-mail: [email protected]

Abstract

Objectives:

This study aimed to compare the interpretations of temporal bone computed tomography scans by an otologist and a radiologist with a special interest in temporal bone imaging. It also aimed to determine the usefulness of this imaging modality.

Methods:

A head and neck radiologist and an otologist separately reported pre-operative computed tomography images using a structured proforma. The reports were then compared with operative findings to determine their accuracy and differences in interpretations.

Results:

Forty-eight patients who underwent pre-operative computed tomography scans in a 30-month period were identified. Six patients were excluded because complete operative findings had not been recorded. Positive and negative predictive values and accuracy of the anatomical and pathological findings were calculated for 42 patients by both reporters. The accuracy was found to be less than 80 per cent, except for identification of the tegmen and lateral semicircular canal erosion. Overall, there was no significant difference in interpretations of computed tomography scans between reporters. There was a slight difference in interpretation for tympanic membrane retraction, facial canal erosion and lateral semicircular canal fistula and/or erosion.

Conclusion:

Pre-operative computed tomography scanning of the temporal bone is useful for predicting anatomy for surgical planning in patients with chronic otitis media, but its reliability remains questionable.

Type
Main Articles
Copyright
Copyright © JLO (1984) Limited 2016 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

Presented as a poster at the British Academic Conference in Otolaryngology, 4–7 July 2012, Glasgow, UK, and as a poster at the Politzer Society Meeting, 13–17 November 2013, Antalya, Turkey

References

1Walshe, P, McConn Walsh, R, Brennan, P, Walsh, M. The role of computerized tomography in the preoperative assessment of chronic suppurative otitis media. Clin Otolaryngol 2002;27:95–7CrossRefGoogle ScholarPubMed
2Yates, PD, Flood, LM, Banerjee, A, Clifford, K. CT scanning of middle ear cholesteatoma: what does the surgeon want to know? Br J Radiol 2002;75:847–52CrossRefGoogle ScholarPubMed
3Blevins, NH, Carter, BL. Routine preoperative imaging in chronic ear surgery. Am J Otol 1998;19:527–38Google ScholarPubMed
4O'Donoghue, GM, Bates, GJ, Anslow, P, Rothera, MP. The predictive value of high resolution computerized tomography in chronic suppurative ear disease. Clin Otolaryngol Allied Sci 1987;12:8996CrossRefGoogle ScholarPubMed
5Alzoubi, FQ, Odat, HA, Al-Balas, HA. Saeed SR. The role of preoperative CT scan in patients with chronic otitis media. Eur Arch Otorhinolaryngol 2009;266:807–9CrossRefGoogle ScholarPubMed
6Wang, LE, Gu, YF, Wu, YQ, Zhuang, QX, Lin, Y, Yin, SK. Significance of CT in diagnosis of chronic suppurative otitis media [in Chinese]. Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2007;42:494–8Google ScholarPubMed
7Garber, LZ, Dort, JC. Cholesteatoma: diagnosis and staging by CT scan. J Otolaryngol 1994;23:121–4Google ScholarPubMed
8Vlastarakos, PV, Kiprouli, C, Pappas, S, Xenelis, J, Maragoudakis, P, Troupis, G et al. CT scan versus surgery: how reliable is the preoperative radiological assessment in patients with chronic otitis media? Eur Arch Otorhinolaryngol 2012;269:81–6CrossRefGoogle ScholarPubMed
9Tatlipinar, A, Tuncel, A, Öğredik, EAGökçeer, T, Uslu, C. The role of computed tomography scanning in chronic otitis media. Eur Arch Otorhinolaryngol 2012;269:33–8CrossRefGoogle ScholarPubMed
10Mafee, MF, Levin, BC, Applebaum, EL, Campos, M, James, CF. Cholesteatoma of the middle ear and mastoid. A comparison of CT scan and operative findings. Otolaryngol Clin North Am 1988;21:265–93CrossRefGoogle ScholarPubMed
11O'Reilly, BJ, Chevretton, EB, Wylie, I, Thakkar, C, Butler, P, Sathanathan, N et al. The value of CT scanning in chronic suppurative otitis media. J Laryngol Otol 1991;105:990–4CrossRefGoogle ScholarPubMed
12Teschner, M, Hinz, K, Stöver, T, Lenarz, T, Becker, H. Diffusion-weighted MRI in the diagnosis of cholesteatomas. ORL J Otorhinolaryngol Relat Spec 2009;71:99104CrossRefGoogle ScholarPubMed
13Vercruysse, JP, De Foer, B, Somers, TCasselman, J, Offeciers, E. Magnetic resonance imaging of cholesteatoma: an update. B-ENT 2009;5:233–40Google ScholarPubMed
14Jackler, RK, Dillon, WP, Schindler, RA. Computed tomography in suppurative ear disease: a correlation of surgical and radiographic findings. Laryngoscope 1984;94:746–52CrossRefGoogle ScholarPubMed