Razek AAKA, Ghonim MR, Ashraf B. Computed Tomography Staging of Middle Ear Cholesteatoma.
Pol J Radiol 2015;
80:328-33. [PMID:
26171086 PMCID:
PMC4485650 DOI:
10.12659/pjr.894155]
[Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2015] [Accepted: 04/09/2015] [Indexed: 11/24/2022] Open
Abstract
Background
To establish computed tomography (CT) staging of middle ear cholesteatoma and assess its impact on the selection of the surgical procedure.
Material/Methods
Prospective study was conducted on 61 consecutive patients (mean age 26.8 years) with middle ear cholesteatoma. CT scan of the temporal bone and surgery were performed in all patients. CT staging classified cholesteatoma according to its location in the tympanic cavity (T); extension into the mastoid (M); and associated complications (C). Cholesteatoma was staged as stage I (T1, T2), stage II (T3, M1, M2, C1), and stage III (C2).
Results
The overall sensitivity of CT staging of cholesteatoma compared to surgery was 88% with excellent agreement and correlation between CT findings and intra-operative findings (K=0.863, r=0.86, P=0.001). There was excellent agreement and correlation of CT staging with surgical findings for T location (K=0.811, r=0.89, P=0.001), good for M extension (K=0.734, r=0.88, P=0.001), and excellent for associated C complications (K=1.00, r=1.0, P=0.001). Atticotympanotomy was carried out in stage I (n=14), intact canal wall surgery was performed in stage II (n=38), and canal wall down surgery was done in stage III (n=5) and stage II (n=4).
Conclusions
We established CT staging of middle ear cholesteatoma that helps surgeons to select an appropriate surgery.
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