Publication:

Preoperative high-resolution computed tomography temporal bone evaluation in patients with chronic otitis media-squamous disease and its correlation with intraoperative findings

Background Chronic otitis media (COM) with squamous disease is a significant cause of morbidity and may lead to serious intratemporal and intracranial complications if not adequately evaluated. High-resolution computed tomography (HRCT) of the temporal bone plays a key role in preoperative assessment; however, its diagnostic accuracy requires validation with intraoperative findings. Objectives were to evaluate the diagnostic accuracy of HRCT temporal bone in patients with COM-squamous disease and to correlate radiological findings with intraoperative findings.

Methods This was a hospital-based observational study conducted on 55 patients diagnosed with COM-squamous disease who underwent HRCT temporal bone followed by surgical management. HRCT findings regarding disease extent and bony erosion were compared with intraoperative findings, which were considered the gold standard. Diagnostic performance parameters including sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were calculated.

Results HRCT demonstrated high sensitivity (96.3%) in detecting disease involvement, with a specificity of 50.0%. The PPV and NPV were 86.7% and 80.0%, respectively. Good correlation was observed between HRCT and intraoperative findings for major bony structures and ossicular erosion. However, reduced accuracy was noted in assessing smaller structures such as the stapes, facial canal, and lateral semicircular canal.

Conclusions HRCT is a valuable preoperative imaging modality in COM-squamous disease, demonstrating high sensitivity and good correlation with intraoperative findings. Despite limitations in soft tissue differentiation and evaluation of small structures, HRCT remains an essential tool for surgical planning; adjunctive imaging such as MRI may be useful in selected cases.