Hostname: page-component-586b7cd67f-tf8b9 Total loading time: 0 Render date: 2024-11-26T12:02:38.386Z Has data issue: false hasContentIssue false
  • English
  • Français

Pre-operative prediction of cholesteatomas from radiology: retrospective cohort study of 106 cases

Published online by Cambridge University Press:  07 June 2019

D Selwyn ,
J Howard  and
P Cuddihy
D Selwyn*
Affiliation:
Department of ENT, Royal Gwent Hospital, Newport, Wales, UK
J Howard
Affiliation:
Department of ENT, Royal Gwent Hospital, Newport, Wales, UK
P Cuddihy
Affiliation:
Department of ENT, Royal Gwent Hospital, Newport, Wales, UK
*
Author for correspondence: Dr David Selwyn, Department of Surgery, Bradford Royal Infirmary, Duckworth Lane, Bradford BD9 6RJ, UK E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Objective

Pre-operative imaging is often used to predict the extent of a cholesteatoma and anatomical variation to plan for surgery. This study aimed to measure the predictive accuracy of computed tomography findings.

Methods

A retrospective cohort study was conducted of all patients in a district general hospital undergoing mastoid surgery within a consecutive 12-month period, in whom computed tomography had been performed prior to operative intervention. The study measured the key findings of pre-operative computed tomography imaging and compared them to the intra-operative findings.

Results

A total of 106 patients were included. The sensitivity and specificity for predicting cholesteatoma were 79 per cent and 81 per cent respectively. The positive predictive value was 90 per cent and the negative predictive value was 65 per cent. In predicting complications of cholesteatomas, the sensitivity was 70 per cent, whereas the specificity was 91 per cent. The positive predictive value was 88 per cent and the negative predictive value was 76 per cent.

Conclusion

Pre-operative computed tomography conducted prior to mastoid surgery has high positive predictive values for both predicting cholesteatomas and complications (90 per cent and 88 per cent respectively).

Keywords

CholesteatomaMastoidComputed TomographyX-Ray
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 133 , Issue 6 , June 2019 , pp. 477 - 481
Copyright
Copyright © JLO (1984) Limited, 2019 

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

Dr D Selwyn takes responsibility for the integrity of the content of the paper

References

1Prata, A, Antunes, M, de Abreu, C, Frazatto, R, Lima, B. Comparative study between radiological and surgical findings of chronic otitis media. Int Arch Otorhinolaryngol 2010;15:72–8Google Scholar
2Walshe, 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;27:95–7Google Scholar
3Yildirim-Baylan, M, Ozmen, CA, Gun, R, Yorgancilar, E, Akkus, Z, Topcu, I. An evaluation of preoperative computed tomography on patients with chronic otitis media. Indian J Otolaryngol Head Neck Surg 2012;64:67–70Google Scholar
4Khavasi, P, Malashetti, S, Chandrashekarayya, SH. An evaluation of preoperative high resolution computed tomography of temporal bone in cholesteatoma. Int J Otorhinolaryngol Head Neck Surg 2018;4:413–17Google Scholar
5Das, CP, Ranjan Rout, M, Shilpa Sri, G, Mohanty, D, Vittal Prasad, P. A study of the clinical correlation of clinical features, radiological and operative findings in chronic suppurative otitis media with cholesteatoma. Indian J Appl Res 2017;7:10–13Google Scholar
6Karki, S, Pokharel, M, Suwal, S, Poudel, R. Correlation between preoperative high resolution computed tomography (CT) findings with surgical findings in chronic otitis media (COM) squamosal type. Kathmandu Univ Med J (KUMJ) 2017;15:83–6Google Scholar
7Mohamed, AY, Yousif, YM, Mehnab, S. Mastoid surgery: clinical findings, radiological findings and technique of mastoid surgery in Khartoum ENT Hospital and Omdurman Military Hospital. Int J Curr Res Med Sci 2017;3:105–9Google Scholar
8Chintale, SG, Kirdak, VR, Jatale, SP, Shaikh, K. Correlation of HRCT mastoid with clinical presentation and operative findings in ear diseases. Int J Otorhinolaryngol Head Neck Surg 2017;3:656–60Google Scholar
9Kumaresan, S, Nirmala, M. Usefulness of pre-operative high-resolution computed tomography in middle ear cholesteatoma. Int J Sci Study 2017;5:248–51Google Scholar
10Jackler, RK, Dillon, WP, Schindler, RA. Computed tomography in suppurative ear disease: a correlation of surgical and radiographic findings. Laryngoscope 1984;94:746–52Google Scholar
11Alzoubi, FQ, Odat, HA, Al-Balas, HA, Saeed, SR. The role of preoperative CT scan in patients with chronic otitis media. Eur Arch Otorhinolaryngol 2009;266:807–9Google Scholar
12Tatlipinar, A, Tuncel, A, Öğredik, EA, Gökçeer, T, Uslu, C. The role of computed tomography scanning in chronic otitis media. Eur Arch Otorhinolaryngol 2012;269:33–8Google Scholar
13Gerami, H, Naghavi, E, Wahabi-Moghadam, M, Forghanparast, K, Akbar, MH. Comparison of preoperative computerized tomography scan imaging of temporal bone with the intraoperative findings in patients undergoing mastoidectomy. Saudi Med J 2009;30:104–8Google Scholar
14Rogha, M, Hashemi, SM, Mokhtarinejad, F, Eshaghian, A, Dadgostar, A. Comparison of preoperative temporal bone CT with intraoperative findings in patients with cholesteatoma. Iran J Otorhinolaryngol 2014;26:7–12Google Scholar
15Payal, G, Pranjal, K, Gul, M, Mittal, MK, Rai, AK. Computed tomography in chronic suppurative otitis media: value in surgical planning. Indian J Otolaryngol Head Neck Surg 2012;64:225–9Google Scholar
16Park, KH, Park, SI, Kwon, J, Kim, YM, Park, IY, Sung, KJ. High-resolution computed tomography of cholesteatomatous otitis media: significance of preoperative information. Yonsei Med J 1988;29:367–72Google Scholar
17Chee, NW, Tan, TY. The value of pre-operative high resolution CT scans in cholesteatoma surgery. Singapore Med J 2001;42:155–9Google Scholar
18O'Donoghue, GM, Bates, GJ, Anslow, P, Rothera, MP. The predictive value of high resolution computerized tomography in chronic suppurative ear disease. Clin Otolaryngol 1987;12:89–96Google Scholar
19O'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;105:990–4Google Scholar
20Badran, K, Ansari, S, Al Sam, R, Al Husami, Y, Iyer, A. Interpreting pre-operative mastoid computed tomography images: comparison between operating surgeon, radiologist and operative findings. J Laryngol Otol 2016;130:32–7Google Scholar
21Faramarzi, M, Roosta, S. Incidence of facial nerve dehiscence in primary and revision cholesteatoma surgery. Indian J Otolaryngol Head Neck Surg 2017;69:300–6Google Scholar
22Sethi, N, Rafferty, A, Kayarkar, R. How reliable is preoperative temporal bone CT in mastoid surgery? J Otol Rhinol 2015;4:3Google Scholar
23Bateman, ND, Carney, AS, Gibbin, KP. An audit of the quality of operation notes in an otolaryngology unit. J R Coll Surg Edinb 1999;44:94–5Google Scholar