How Reliable is Preoperative Temporal Bone CT in Mastoid Surgery?

How Reliable is Preoperative Temporal Bone CT in Mastoid Surgery?

Objective: To evaluate the reliability of high resolution computerized tomography (HRCT) of the temporal bone in assessing local complications of active squamous chronic otitis media (cholesteatoma) preoperatively.

Methods: 156 patients having undergone mastoid surgery were identified. Prospectively collected intraoperative information was compared to preoperative findings for four specific parameters.

Results: Relatively low sensitivities for all four parameters were found ranging from 11% for facial nerve canal dehiscence to 35% for ossicular chain erosion.

Conclusions: This study emphasises the need for surgeons not to be misled by preoperative HRCT. The role of imaging in anticipating complications is by no means definitive.