Chronic inflammatory middle ear disease: Postoperative CT and MRI findings

Abstract

Aim To prospectively evaluate the value of CT and MRI in diagnosis of middle ear pathologies following operation for chronic otitis media (COM). Patients and methods Fifty patients, who had been operated on for chronic middle ear disease, were referred for either CT alone or followed by MRI depending on the different case scenarios. Imaging findings were correlated with surgical findings. Results CT alone was done in 10 patients; 6/10 showed a free mastoidectomy cavity and 4/10 showed a clear cavity with abnormal position of the prosthesis. The rest of the 40 patients did a CT followed by MRI which showed granulation tissue in 17 patients, cholesteatoma in 13/14 patients of which one showed intracranial extension, combined granulation tissue with cholesteatoma in 5/6 patients, cholesterol granuloma in 2 patients and meningocele in another 2 patients. Overall CT sensitivity and specificity was 46.25% and 90.77% and MRI sensitivity and specificity was 95.23% and 99.16% respectively. Conclusion CT and MRI are both safe non-invasive diagnostic methods. Both procedures can provide radiologists a confident diagnosis of postoperative middle ear complications, assisting otologists with a provisional diagnosis for a better management.