Correlation Between Preoperative HRCT Temporal Bone Findings and Intraoperative Findings in Patients with Chronic Otitis Media Active Squamosal Disease.

This study was done to evaluate the role of high resolution computed tomography temporal bone as a diagnostic modality in Cholesteatoma and its usefulness in determining the extent of disease in Chronic Otitis Media Active Squamosal Disease and to correlate its findings with surgical findings. This study was conducted on patients with chronic otitis media active squamosal disease as an observational study over the period of 18 months (August 2022-January 2024). HRCT temporal bone was done and intra operative findings were noted and correlated. CT scan correlated with surgical findings for cholesteatoma in 100% cases, involvement of mastoid in 98.8% cases and ossicular erosion in 97.6% cases. Perfect level of agreement was noted for intracranial complications (100%; κ = 1;  < 0.05). Near perfect level of agreement between CT scan findings and surgical findings was found for widening of aditus (98.6%; κ = 0.94:  < 0.05), high jugular bulb (87.5%; κ = 0.92;  < 0.05), Prussak space involvement (93.7%; κ0.872;  < 0.05), erosion of scutum (87.2%; κ = 0.85;  < 0.05) and erosion of sinus plate (80%; κ = 0.83;  < 0.05). Pre-operative HRCT of temporal bone is essential for evaluation of patients with COM as it helps in decision making regarding the mastoid surgery. It helps in providing information regarding the anatomical structures, congenital anomalies, extent of disease, condition of ossicles, sinus plate, dural plate, lateral semicircular canal and facial canal as well as in determining intracranial complications. Despite the fact that HRCT is associated with radiation exposure and is a costly investigation, it helps in assisting the surgeon during the surgery.