Role of computed tomography in diagnosis of complications in chronic suppurative otitis media

Abstract

Chronic otitis media is chronic inflammation of middle ear cavity, it present with longstanding discharging ear and perforated tympanic membrane with or without cholesteatoma and other complications. Cross sectional study was performed to identify the role of computed tomography in diagnosis of complications in chronic suppurative otitis media among 40 patients between June 2018 and June 2019. Aim: To identify role of CT scan in diagnosis of anatomical and pathological effects of chronic suppurative otitis media as: pneumatisation of mastoid, soft tissue mass in middle ear cleft and mastoid, cholesteatoma, bones erosions, facial nerve canal dehiscence, labyrinthine and semicircular canal fistula.Patient and Methods: 40 patients included in our study between period June 2018 to June 2019, they are referred from otology department to radiology department in AL Hillah General Teaching Hospital that thin slices CT temporal bone was taken for all these patients. Results: Age incidence: between 15-20 years was 3 of 40 patients (7.5%), 20-40 was 25 (62.5%), 40-50 was 12 0f 40 patients (30%). Mean age is 32.77 years. 16 of 40 patients were female (40%), 24 of 40 patients were male (60%).Male to female ratio 1.5:1. Incidence of symptoms and signs was: headache & pain in 6 patients (15%), vertigo in 5 (12.5%), hearing loss in 30 (75%), discharging ear in 40 (100%), and facial palsy in 2 (5%). Pathology in middle ear: Granulation in 20 cases (50%), cholesteatoma in 15 (37.5%), and polyp in 5 (12.5%). Pneumatisation of mastoid bone: well in 25 cases (62.5%), sclerotic in 13 (32.5%), and poor in 2 (5%). Middle ear and mastoid mass: in CT scan 25 cases (62.5%) and in surgery 24 (60%). Cholesteatoma incidence: in CT scan 15 cases (37.5%) and in surgery 15 (37.5%). Incidence of complications: scutum erosion in CT 14 (35%) in surgery 15 (37.5%), ossicular erosion in CT 11 (27.5%), in surgery 8 (20%), facial canal dehiscence in CT 2 (5%), in surgery 3 (7.5%), labyrinthine fistula in CT 2 (5%), in surgery 1 (2.5%), semicircular canal fistula in CT 3 (7.5%), in surgery 2 (5%), tegument erosion in CT 1 (2.5%), in surgery 2 (5%), and tegument tympani erosion in CT 1 (2.5%) in surgery 1 (2.5%).