Diagnosis of unsafe chronic suppurative otitis media using computed tomography through predictive value assessments

Background: Chronic Suppurative Otitis Media (CSOM) is a significant cause of preventable hearing loss. Global emergence of resistant strains is of great concern. The aim of the present study was to assess the accuracy and predictive value of computed tomography in diagnosis of unsafe chronic suppurative otitis media. Methods: Aprospective, analytical study was conducted among 90 patients with complaint of unsafe chronic suppurative otitis media which were randomly selected from outpatient Department of Otorhinolaryngology at Subharti Medical College, Dehradun, Uttarakhand. The patients comprised of both males as well as females and also of different age groups. Results: Out of 90 patients, 61(67.22%) were males followed by 29 (32.22%) females. The minimum age of patient in the study was of 8years and the maximum age of patient in study of 50 years. Maximum number of patients belonged to the age group of 11-20 (50%). The mean age in this study was 23 years. Among study subjects, 32 (35.55%) cases had conductive hearing loss, 11 (12.22%) cases had sensorineural type, 40 (44.44%) had mixed type and 7 (7.77%) had no response. In this study, sensitivity, specificity, positive predictive value, negative predictive value was calculated of computed tomography findings as compared to preoperative findings. The sensitivity of HRCT for mastoid was 100%, visualization malleus was 94.11%, incus was also 62.31%, stapes was 47.22% and facial N dehiscent and intact was 44.82%. Similarly, the specificity of CT scan for mastoid was 83.33%, malleus was 92.85%, incus was 61.90%, stapes erosion was 37.03% and facial N dehiscent was 96.72%. Conclusion: The present study was concluded that computed tomography can accurately image the findings in unsafe chronic suppurative otitis media and represents a major advance in the diagnostic imaging of this disease.