High Resolution Computed Tomography (HRCT) Evaluation of Temporal Bone Infectious Pathologies - A Study from a Tertiary Care Hospital, Valsad, Gujarat

Abstract

BACKGROUND The complicated middle and inner ear anatomy challenge the diagnostic ease in radiological evaluation of the temporal bone. Their tiny dimension and close neighbouring of the structures limited the successful imaging facilities for long periods of time. Conventional radiological procedures have been inadequate for diagnostic imaging but recently multidirectional tomography and high-resolution computed tomography (HRCT) has gained importance. Inflammatory and infectious diseases of the temporal bone are a major indication to perform highresolution CT. Such studies allow one to evaluate the extent of the disease in the soft tissues and in the bony structures of the temporal bone. The purpose of this study was to evaluate temporal bone infectious pathologies using high resolution computed tomography (HRCT). METHODS The study is completely observational & retrospective type of study. HRCT of temporal bone was carried out on 50 cases with SIEMENS SOMATOM emotion 16 slice CT scan machine, GMERS Medical College & Hospital, Valsad, Gujarat depending upon the availability from February 2019 to January 2020 including all age groups, both sexes with suspicion of temporal bone infective pathologies based on sign and symptoms. RESULTS Out of 50 patients, 38 patients were diagnosed with chronic suppurative otitis media (CSOM) and 12 patients were diagnosed with acute suppurative otitis media (ASOM), of which 65 % of CSOM showed cholesteatoma formation. All the patients with ASOM showed air-fluid levels. Male to female ratio was nearly 1.77 : 1. Out of which, 52 % were paediatric patients. Common symptoms were ear, discharge, headache and deafness. Most commonly affected site was right side. There were 6 extra cranial and 2 intracranial complications seen. CONCLUSIONS Due to the ability to delineate the bony and soft tissue anatomy with high accuracy, high-resolution CT is the imaging modality of choice for topographic evaluation of temporal infective pathologies and their extracranial and intracranial complications. KEYWORDS ASOM, CSOM, Cholesteatoma, Air Fluid Level, Pneumatization, Ossicles, Middle Ear, Inner Ear, Complications