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High Resolution Computed Tomography of Temporal Bone: The Predictive Value in Atticoantral Disease.

ABSTRACT: To evaluate predictive value of high resolution computed tomography in atticoantral disease. We conducted a prospective observational study in 49 patients suffering from atticoantral disease at tertiary referral institute. Preoperatively, all the patients underwent unenhanced high resolution computed tomography (HRCT) of temporal bone parallel to orbitomeatal line by using multislice scanner. We evaluated presence of soft tissue attenuation, ossicular erosion, facial canal erosion, dural exposure, erosion of semicircular canal, labyrinthine fistula, erosion of scutum and tegmen tympani in CT scan. HRCT is recommended in atticoantral disease with complications. This study demonstrates the predictive value of HRCT of temporal bone as a diagnostic modality in atticoantral disease. HRCT shows 100% sensitivity (Sn) of soft tissue density detected in middle ear, aditus and attic. Specificity (Sp) was more for eustechian tube area and sinus tympani. Ossicular erosions of malleus (Sn?=?90.9%, Sp?=?75%), incus (Sn?=?93.2%, Sp?=?80%), stapes (Sn?=?78.8%, Sp?=?68.8%) were detected. Erosion of scutum (Sn?=?94.1%, Sp?=?80%), tegmen (Sn?=?66.7%, Sp?=?100%), sinus plate (Sn?=?100%, Sp?=?97.9%), facial nerve canal (Sn?=?75%, Sp?=?100%), semicircular canal fistula (Sn?=?80%, Sp?=?97.7%) and cochlear promontory fistula (Sn?=?50%, Sp?=?97.9%) were evaluated. HRCT temporal bone helps to evaluate disease extent and involvement of surrounding structures. Hence it helps in deciding surgical approach and also prevents impending complications.

SUBMITTER: Mandal S

PROVIDER: S-EPMC6841787 | biostudies-literature | 2019 Nov

REPOSITORIES: biostudies-literature

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High Resolution Computed Tomography of Temporal Bone: The Predictive Value in Atticoantral Disease.

Mandal Shantanu S Muneer K K Roy Manaswita M

Indian journal of otolaryngology and head and neck surgery : official publication of the Association of Otolaryngologists of India 20180810 Suppl 2

To evaluate predictive value of high resolution computed tomography in atticoantral disease. We conducted a prospective observational study in 49 patients suffering from atticoantral disease at tertiary referral institute. Preoperatively, all the patients underwent unenhanced high resolution computed tomography (HRCT) of temporal bone parallel to orbitomeatal line by using multislice scanner. We evaluated presence of soft tissue attenuation, ossicular erosion, facial canal erosion, dural exposur ...[more]

PMID: 31750183

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Project description:High resolution peripheral quantitative computed tomography (HR-pQCT) is a 3-dimensional imaging modality with superior sensitivity for bone changes and abnormalities. Recent advances have led to increased use of HR-pQCT in inflammatory arthritis to report quantitative volumetric measures of bone density, microstructure, local anabolic (e.g., osteophytes, enthesiophytes) and catabolic (e.g., erosions) bone changes and joint space width. These features may be useful for monitoring disease progression, response to therapy, and are responsive to differentiating between those with inflammatory arthritis conditions and healthy controls. We reviewed 69 publications utilizing HR-pQCT imaging of the metacarpophalangeal (MCP) and/or wrist joints to investigate arthritis conditions. Erosions are a marker of early inflammatory arthritis progression, and recent work has focused on improvement and application of techniques to sensitively identify erosions, as well as quantifying erosion volume changes longitudinally using manual, semi-automated and automated methods. As a research tool, HR-pQCT may be used to detect treatment effects through changes in erosion volume in as little as 3 months. Studies with 1-year follow-up have demonstrated progression or repair of erosions depending on the treatment strategy applied. HR-pQCT presents several advantages. Combined with advances in image processing and image registration, individual changes can be monitored with high sensitivity and reliability. Thus, a major strength of HR-pQCT is its applicability in instances where subtle changes are anticipated, such as early erosive progression in the presence of subclinical inflammation. HR-pQCT imaging results could ultimately impact decision making to uptake aggressive treatment strategies and prevent progression of joint damage. There are several potential areas where HR-pQCT evaluation of inflammatory arthritis still requires development. As a highly sensitive imaging technique, one of the major challenges has been motion artifacts; motion compensation algorithms should be implemented for HR-pQCT. New research developments will improve the current disadvantages including, wider availability of scanners, the field of view, as well as the versatility for measuring tissues other than only bone. The challenge remains to disseminate these analysis approaches for broader clinical use and in research.

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Dataset Information

High Resolution Computed Tomography of Temporal Bone: The Predictive Value in Atticoantral Disease.

Publications

High Resolution Computed Tomography of Temporal Bone: The Predictive Value in Atticoantral Disease.

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