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

  • Dr. Naveen Shukla Assistant Professor, Department of Otorhinolaryngology at Shridev Suman Subharti Medical College, Dehradun, India
  • Dr. Rakesh Kumar Giri Senior Resident, Department of Otorhinolaryngology at Shridev Suman Subharti Medical College, Dehradun, India
  • Dr. Varuni Sharma Assistant Professor, Department of Obstetrics and Gynaecology, Shridev Suman Subharti Medical College, Dehradun, Uttarakhand, India
Keywords: Chronic suppurative otitis media, Predictive value, Computed tomography

Abstract

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.

Downloads

Download data is not yet available.

References

1. Shenoi PM. Management of chronic suppurative otitis media. In: Booth JB, editor. Scott Browns otolaryngology. 5. London: Butterworths; 1987. pp. 215–237.

2. WHO/CIBA Foundation workshop report, Prevention of hearing impairment from chronic otitis media.UK 19–21 Nov 1996.

3. Varshney S, Nangia A, Bist SS, Singh RK, Gupta N, Bhagat S. Ossicular chain status in chronic suppurative otitis media in adults. Indian J Otolaryngol Head Neck Surg. 2011;62(4):421–426. doi:10.1007/s12070-010-0116-3

4. Agarwal NM, Popat VC, Traviad C, et al. Clinical and histopathological study of mass in ear: a study of fifty cases. Indian J Otolaryngol Head Neck Surg. 2013 Dec;65(Suppl 3):520-5. doi: 10.1007/s12070-011-0434-0. Epub 2012 Feb 11.[pubmed]

5. Mishiro Y., Sakagami M., Takahashi Y., Kitahara T., Kajikawa H., Kubo T. Tympanoplasty with and without mastoidectomy for non-cholesteatomatous chronic otitis media. Eur Arch Otorhinolaryngol. 2001. 258 13–15. doi:10.1007/PL00007516 . [pubmed]

6. Worku M, Bekele M. Bacterial isolate and antibacterial resistance pattern of ear infection among patients attending at Hawassa university referral Hospital, Hawassa, Ethiopia. Indian J Otol2014;20:155-9.

7. Chronic suppurative otitis media - burden of illness and management options; World Health Organization, 2004.

8. Singh A, Pandey S and Gaur A. “Burden of non-communicable diseases on two different division of Uttarakhand: Adult health indicator”, International Journal of Development Research, 2018. 8, (12), 24480-24485.

9. Chee NW, Tan TY. The value of pre-operative high resolution CT scans in cholesteatoma surgery. Singapore Med J. 2001 Apr;42(4):155-9.[pubmed]

10. Tatlipinar, A., Tuncel, A., Öğredik, E. A., Gökçeer, T., &Uslu, C. The role of computed tomography scanning in chronic otitis media. Eur Arch Otorhinolaryngol. 2012 Jan;269(1):33-8. doi: 10.1007/s00405-011-1577-z.

11. Jackler RK, Dillon WP, Schindler RA. Computed tomography in suppurative ear disease: a correlation of surgical and radiographic findings. Laryngoscope. 1984 Jun;94(6):746-52.[pubmed]

12. Kangsanarak J, Fooanant S, Ruckphaopunt K, et al. Extracranial and intracranial complications of suppurative otitis media. Report of 102 cases. J Laryngol Otol. 1993 Nov;107(11):999-1004.[pubmed]

13. Singh B, Maharaj TJ. Radical mastoidectomy: its place in otitic intracranial complications. J Laryngol Otol. 1993 Dec;107(12):1113-8.[pubmed]

14. Lampikoski H, Aarnisalo AA, Jero J, et al. Mastoid biofilm in chronic otitis media. OtolNeurotol. 2012 Jul;33(5):785-8. doi: 10.1097/MAO.0b013e318259533f.[pubmed]

15. Gaurano JL, Joharjy IA. Middle ear cholesteatoma: characteristic CT findings in 64 patients. Ann Saudi Med. 2004 Nov-Dec;24(6):442-7. DOI:10.5144/0256-4947.2004.442.

16. O'Donoghue G M, Bates G J. Anslow P. Rothera P. The predictive value of high resolution computerized tomography in chronic suppurative ear disease. Clinical otolaryngology 1983;12:89-96. https://doi.org/10.1111/j.1365-2273.1987.tb00168.x

17. Mafee MF, Levin BC, Applebaum EL, et al. Cholesteatoma of the middle ear and mastoid. A comparison of CT scan and operative findings. Otolaryngol Clin North Am. 1988 May;21(2):265-93.[pubmed]

18. O'Reilly BJ, Chavertton Ear B, Wylie.l, Thakkar C, Butler P, Sathanathan N, Morrison GA, Kenyon GS. Value of computed tomography scanning in chronic suppurative otitis media; J of Laryngology and Otology Dec 1991;105:990-994.

19. Shaffer, K. A., Haughton, V. M., Wilson, C. R. (1980). High Resolution Computed Tomography of the Temporal Bone. Radiology, 134:409–414.[pubmed]

20. Pandey S, Singh A, Gaur A. Polynomial approach modeling among diabetic patients associated with age in rural hilly population of Dehradun district, Uttarakhand. Int J Res Med Sci 2018;6:1-5. DOI: 10.18203/2320-6012.ijrms20180615

21. Payal, G., Pranjal, K., Gul, M., Mittal, M. K., & Rai, A. K. (2012). Computed tomography in chronic suppurative otitis media: value in surgical planning. Indian journal of otolaryngology and head and neck surgery: official publication of the Association of Otolaryngologists of India,64(3), 225–229. doi:10.1007/s12070-011- 0325-4.

22. Kvestad E, Kvaerner KJ, Mair IWS. Acute Mastoiditis: predictors for surgery. Int J. Pediatr. Otorhinolaryngol. 2000;52:149-55.

23. Freng A, Larsen PL, Nordhus T. Cholesteatoma of the temporal bone. Preoperative CT versus Peroperative findings. Scandinavian Audiology Supplement. 1988; 30:185-188.
Diagnosis of unsafe chronic suppurative otitis media using computed tomography through predictive value assessments
CITATION
DOI: 10.17511/jooo.2019.i02.03
Published: 2019-06-30
How to Cite
Shukla, N., Kumar Giri, R., & Sharma, V. (2019). Diagnosis of unsafe chronic suppurative otitis media using computed tomography through predictive value assessments. Tropical Journal of Ophthalmology and Otolaryngology, 4(2), 80-85. https://doi.org/10.17511/jooo.2019.i02.03
Section
Original Article