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The value of CT scanning in chronic suppurative otitis media

Published online by Cambridge University Press:  29 June 2007

B. J. O'Reilly*
Affiliation:
Departments of Otolaryngology, The Royal London Hospital, Whitechapel, London E1 1RB.
E. B. Chevretton
Affiliation:
Departments of Otolaryngology, The Royal London Hospital, Whitechapel, London E1 1RB.
I. Wylie
Affiliation:
Departments of Neuroradiology, The Royal London Hospital, Whitechapel, London E1 1RB.
C. Thakkar
Affiliation:
Departments of Neuroradiology, The Royal London Hospital, Whitechapel, London E1 1RB.
P. Butler
Affiliation:
Departments of Neuroradiology, The Royal London Hospital, Whitechapel, London E1 1RB.
N. Sathanathan
Affiliation:
Departments of Neuroradiology, The Royal London Hospital, Whitechapel, London E1 1RB.
G. A. Morrison
Affiliation:
Departments of Otolaryngology, The Royal London Hospital, Whitechapel, London E1 1RB.
G. S. Kenyon
Affiliation:
Departments of Otolaryngology, The Royal London Hospital, Whitechapel, London E1 1RB.
*
Address for correspondence: Sqn. Ldr. B. J. O'Reilly, F.R.C.S.Ed., E.N.T. Department, Princess Mary's Hospital, Halton, Aylesbury, Bucks HP22 5PS.

Abstract

High definition CT has been advocated for the evaluation of chronic suppurative otitis media (CSOM) either generally or in selected cases. It is said to be capable of producing the fine detail needed to detect lateral canal fistulae, exposed dura and facial canal dehiscences, and to demonstrate the ossicular chain. At present there is no agreement on either the indications for CT scanning in CSOM or the most appropriate scanning plane. To determine the value of high definition CT in CSOM and to decide a unit policy for its application, 36 cases of CSOM underwent pre-operative CT scanning and their scans were compared with the operative findings.

Our results show CT to be highly sensitive to the presence of soft tissue disease and bone erosion, moderately sensitive to the presence of lateral canal fistulae but less sensitive to the presence of small areas of exposed dura, ossicular continuity and facial canal dehiscence. Axial scans were better able to demonstrate the lateral canal but otherwise coronal scans were superior; ideally patients should be scanned in both planes. The principle value of CT in CSOM is its ability to demonstrate disease which is not clinically apparent.

Type
Main Articles
Copyright
Copyright © JLO (1984) Limited 1991

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