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The value of CT scanning in chronic suppurative otitis media

Published online by Cambridge University Press:  29 June 2007

B. J. O'Reilly*
Affiliation:
Departments of Otolaryngology, The Royal London Hospital, Whitechapel, London E1 1RB.
E. B. Chevretton
Affiliation:
Departments of Otolaryngology, The Royal London Hospital, Whitechapel, London E1 1RB.
I. Wylie
Affiliation:
Departments of Neuroradiology, The Royal London Hospital, Whitechapel, London E1 1RB.
C. Thakkar
Affiliation:
Departments of Neuroradiology, The Royal London Hospital, Whitechapel, London E1 1RB.
P. Butler
Affiliation:
Departments of Neuroradiology, The Royal London Hospital, Whitechapel, London E1 1RB.
N. Sathanathan
Affiliation:
Departments of Neuroradiology, The Royal London Hospital, Whitechapel, London E1 1RB.
G. A. Morrison
Affiliation:
Departments of Otolaryngology, The Royal London Hospital, Whitechapel, London E1 1RB.
G. S. Kenyon
Affiliation:
Departments of Otolaryngology, The Royal London Hospital, Whitechapel, London E1 1RB.
*
Address for correspondence: Sqn. Ldr. B. J. O'Reilly, F.R.C.S.Ed., E.N.T. Department, Princess Mary's Hospital, Halton, Aylesbury, Bucks HP22 5PS.

Abstract

High definition CT has been advocated for the evaluation of chronic suppurative otitis media (CSOM) either generally or in selected cases. It is said to be capable of producing the fine detail needed to detect lateral canal fistulae, exposed dura and facial canal dehiscences, and to demonstrate the ossicular chain. At present there is no agreement on either the indications for CT scanning in CSOM or the most appropriate scanning plane. To determine the value of high definition CT in CSOM and to decide a unit policy for its application, 36 cases of CSOM underwent pre-operative CT scanning and their scans were compared with the operative findings.

Our results show CT to be highly sensitive to the presence of soft tissue disease and bone erosion, moderately sensitive to the presence of lateral canal fistulae but less sensitive to the presence of small areas of exposed dura, ossicular continuity and facial canal dehiscence. Axial scans were better able to demonstrate the lateral canal but otherwise coronal scans were superior; ideally patients should be scanned in both planes. The principle value of CT in CSOM is its ability to demonstrate disease which is not clinically apparent.

Type
Main Articles
Copyright
Copyright © JLO (1984) Limited 1991

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References

Bates, G. J., O'Donoghue, G. M., Anslow, P., Houlding, T. (1988) Can CT Detect Labyrinthine Fistulae Preoperatively? Acta Otolaryngologica, 106: 4045.CrossRefGoogle ScholarPubMed
Freng, A., Larsen, P. L., Nordhus, T. (1988) Cholesteatomas of the Temporal Bone. Preoperative CT Versus Peroperative Findings. Scandinavian Audiology Supplement, 30: 185188.Google Scholar
Jackler, K. R., Dillon, W. P., Schindler, R. A. (1984) Computed Tomography in Suppurative Ear Disease: A Correlation of Surgical and Radiographic Findings. Laryngoscope, 94, 746752.Google Scholar
Johnson, D. W., Voorhees, R. L., Lufkin, R. B., Hanafee, W., Canalis, R. (1983) Cholesteatomas of the Temporal Bone: Role of Computed Tomography. Radiology, 148: 733737.CrossRefGoogle ScholarPubMed
Mafee, F. M., Kumar, A., Yannias, A., Valvassori, G. E., Applebaum, E. L. (1983) Computed Tomography of the Middle Ear in the Evaluation of Cholesteatomas and other Soft-Tissue Masses: Comparison with Pluridirectional Tomograpahy. Radiology, 148: 465472.CrossRefGoogle Scholar
Mafee, M. F., Aimi, K., Kahen, H. L., Valvassori, G. E., Capek, V. (1986) Chronic Otomastoiditis: A Conceptual Understanding of CT Findings, Radiology, 160: 193200.Google Scholar
Mafee, M. F., Levin, B. C., Applebaum, E. L., Campos, M., James, C. F. (1988) Cholesteatoma of the Middle Ear and Mastoid: A Comparison of the CT Scan and Operative Findings. Otolaryngologic Clinics of North America, 21(2): 265293.CrossRefGoogle ScholarPubMed
O'Donoghue, G. M. (1987) Imaging the Temporal Bone (editorial). Clinical Otolaryngology, 12: 157160.Google Scholar
O'Donoghue, G. M., Bates, G. J., Anslow, P., Rothera, M. P. (1987) The Predictive Value of High Resolution Computerized Tomography in Chronic Suppurative Ear Disease. Clinical Otolaryngology, 12: 8996.CrossRefGoogle ScholarPubMed
Phelps, P. D., Wright, A. (1990) Imaging Cholesteatoma. Clinical Radiology, 41: 156162.CrossRefGoogle ScholarPubMed
Shaffer, K. A., Haughton, V. M., Wilson, C. R. (1980). High Resolution Computed Tomography of the Temporal Bone. Radiology, 134: 409414.CrossRefGoogle ScholarPubMed
Sheehy, J. L., Brackmann, D. E., Graham, M. D. (1977) Complications of Cholesteatoma: a Report on 1024 Cases. In First International Conference on Cholesteatoma (McCabe, B. F., Sade, J., Abramson, M., eds.), Aesculapius Press, Birmingham, Alabama, 420429.Google Scholar
Swartz, J. D. (1983) High Resolution Computed Tomography of the Middle Ear and Mastoid. Radiology, 148: 449454.Google Scholar