Radiological changes in anatomy of temporal bone in cases of unsafe chronic suppurative otitis media: A retrospective study

Vinit Kumar Sharma, Neeraj Prajapati, Rohit Sharma, Zafar Iqbal, Shubham Dadoo

Indian Journal of Otology 2017 23(3):176-179

Introduction: The ability of high-resolution computed tomography (HRCT) to depict the status of structure of the temporal bone represents a major advance in delineating pathology before surgical exploration of ear in cases of unsafe chronic suppurative otitis media (CSOM) or cholesteatoma. Aims and Objectives: The aim of this study was to evaluate the role of HRCT temporal bone in cases of unsafe CSOM and to assess the erosion of various structures in middle ear cleft. Study Design: This was a retrospective analysis. Materials and Methods: Fifty HRCT scans of temporal bone of the patients who were diagnosed as case of unsafe CSOM were selected and analyzed retrospectively. Criterion for inclusion was CSOM with cholesteatoma or granulations or polyp or posterior canal wall sagging or foul smelling discharge. In HRCT scans, 1 mm thickness sections were studied in both axial and coronal planes. Criterion for exclusion was history of previous ear surgery, history suggestive of head injury or skull base trauma in the past or known cases of temporal bone neoplastic pathology. Results: Maximum number of patients belonged to the age group of 21–30 years. Ossicular erosion was the most common (90%) finding followed by scutum erosion (84%). Erosion of sigmoid sinus plate was seen in only one case (2%). Cochlear promontory fistula was seen in none of the computed tomography scans. In ossicular chain, incus was the most common ossicle to be necrosed (92%) followed by malleus (66%). Conclusion: HRCT temporal bone delineates the location and extent of the disease and provides information on anatomical variations and complications.

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