Role of High-Resolution Computed Tomography (hrct) Temporal Bone in Different Pathologies

Indian Journal of Applied Basic Medical Sciences
Year: 2020, Volume: 22(B), Issue. (2)
First page: (285) Last page: (305)
Online ISSN: 2249-7935
Print ISSN: 0975-8917
doi:10.48165/ijabms.2020.22222

Role of High-Resolution Computed Tomography (HRCT) Temporal Bone in Different Pathologies
Hiren Doshi1, Karnadev Solnaki2*, Meeta Bathla3, Atul Kansara4, Navdeep Chavda5 and Ritiksha Gajjar6
1Assistant Professor, 23rd Year Resident, 3Associate Professor, 4Professor and HOD, 53rd Year Resident, 61st Year Resident, Ent Surgery; Department Of Ent, L.G. Hospital, AMC-Metmedical College. Maninagar Ahmedabad 380008
Corresponding Author: Karnadev Solanki, Email:kdsolanki28@gmail.com

Online Published on 02-July-2020

ABSTRACT

Background: –High Resolution Computed Tomography (HRCT), a modification of routine CT, provides a direct visual window in the temporal bone providing minute structural details [1]. Purpose of the present study was to evaluate the normal variations, pathological processes (infections and congenital anomalies) and their extent involving the temporal bone along with their complications on HRCT and to correlate these imaging findings surgically.Aim of the Study: –1To find out about the causes, different types of pathologies, male female ratio, and management accordingly.Materials and Methods: –The prospective study included 100 patients who were presented to ENT department of AMC MET MEDICAL COLLEGE with clinically suspected temporal bone or ear pathologies. After detailed clinical examination, the patients were subjected to high resolution computed tomography (HRCT) examination and most of them underwent surgery. The imaging findings were correlated with the surgical findings. The surgical findings were considered as final.Observation and Results: –Of 100 cases examined, we had 93 cases of middle ear cleft pathology (chronic Otitis media,cholesteatoma, soft tissue densities without cholesteatoma) out of which 25 cases werecholesteatoma, 22 cases of soft tissue density in mastoid cavity and 46 cases had middle ear opaque homogenous densities, 4 traumatic cases & 2 congenital pathology.Conclusion: –HRCT is a revolutionary imaging modality that helps in evaluating the distribution features, localization and assessing the extent of various pathologies affecting the temporal bone. The clinical and radiological findings showed a high level sensitivity with intraoperative findings as regards to the presence of cholesteatoma, changes of the ossicular chain and erosion of the lateral semicircular canal. Where criteria for cholesteatoma was soft tissue density in middle ear or mastoid with bony erosion, other cases in this study were 2 congenital cases in which the findings of HRCT were in co-relationship with the intraoperative finding. One case of facial nerve schwannoma was diagnosed on HRCT and confirmed intraoperatively. 4 cases of trauma that stated fracture of longitudinal segment of temporal bone with facial palsy. One needed surgical exploration for facial nerve decompression rest all improved by conservative management. Hence HRCT was very sensitive and specific with various pathologies confirmed intraoperatively.

Keywords

Cholesteatoma, Chronic suppurative otitis media, high resolution computed tomographic scan, temporal bone pathology.