INTRODUCTION:

High resolution computed tomography, provides as direct visual window in the temporal bone providing minute structural details

Chronic suppurative otitis media (CSOM) is a long standing inflammation of the middle ear cleft which can cause severe destruction of the middle ear and mastoid, leading to various sequela

T   TUBOTYMPANIC VARIETY (SAFE) - sequela of acute otitis media, simple perforation of the pars tensa and non - offensive, non bloody discharge.

A   ATTICO-ANTRAL VARIETY (UNSAFE) - cholesteatoma often arises from a postero-superior pocket of the tympanic membrane or as a attic cholesteatoma. Due to expansion it starts eroding the surrounding structures - Scutum and ossicular chain. An expanding cholesteatoma may invade the antrum and mastoid space, bony facial canal, tegmen and lateral semicircular canal.

    AIM:

T  To study the role of HRCT Temporal bone in evaluation of patients with chronic suppurative otitis media (CSOM)

    OBJECTIVES:

     To study the radiological findings (HRCT) of the temporal bone in patients with chronic suppurative otitis media (CSOM).

     To evaluate and determine the efficacy and role of HRCT temporal bone in patients with CSOM  by comparing the pre-operative HRCT temporal bone findings with intra-operative findings (gold standard), whenever available. 

    JUSTIFICATION FOR STUDY:

     Due to strategic location of the tympano-mastoid compartment separated from the middle and posterior cranial fossa by thinnest of bony partitions, otitis media has the potential for intracranial extension.

      HRCT is a guide to the nature of the disease (destructive/non-destructive), potential dangers and possible complications and this information can assist the surgeon in the choice of surgery to be performed (simple or radical mastoidectomy, with or without tympanoplasty). As it is important to recognize the disease early to adopt a surgical procedure, to save the patient from loss of hearing and to prevent the grave intracranial complications, advising the patients a routine HRCT prior to surgery can be justified. It can predict the outcome of the surgery and also helps in discussing these possibilties with the patient.

POTENTIAL RISKS AND BENEFITS:

Risks: Nil

Benefits:A HRCT temporal bone scan is useful for planning the surgical approach, determining the extension and helps to reduce postoperative risks.

Patients will be benefited by diagnosing the extent and in evaluating the prognosis and planning treatment