THE ROLE OF TEMPORAL BONE COMPUTED TOMOGRAPHY IN TYMPANOPLASTY SURGERY
1Sağlık Bilimleri Üniversitesi İzmir Bozyaka Eğitim ve Araştırma Hastanesi, Kulak Burun Boğaz Hastalıkları ve Baş Boyun Cerrahisi Kliniği, İzmir, Türkiye2Sağlık Bilimleri Üniversitesi İzmir Bozyaka Eğitim ve Araştırma Hastanesi, Radyoloji Kliniği, İzmir, Türkiye Aim: Tympanoplasty is one of the most common surgeries in otolaryngology practice and high resolution temporal bone CT scan (HRCT) is commonly used to determine the preoperative anatomy and to determine the extension of the disease. The aim of this study was to compare the pre-operative HRCT findings and intraoperative findings in patients who underwent tympanoplasty and to determine the advantages and disadvantages of HRCT.
Materials and Methods: 85 patients who underwent tympanoplasty with the diagnosis of chronic suppurative otitis media (CSOM) were included in the study. All images were evaluated by a single specialist radiologist. Preoperative HRCT findings, operation findings, preoperative and postoperative 6th month Pure Tone Average (PTA) of patients were retrospectively evaluated by scanning patient files.
Results: The age distribution of the patients was 10-66 (mean 36.6 ± 6.7). 3 (3.5%) patients had intraoperative cholesteatoma. HRCT detected cholesteatoma in 9 patients (positive predictive value: 3/9, 33.3%), excluding cholesteatoma in 76 patients (negative predictive value: 76/82, 92.6%). Incus long arm defect was detected in 9 (10.5%) patients and malleus defect was detected in 2 (2.2%) patients. The specificity of HRCT was 11/14 (78.5%) and sensitivity was 71/74 (95.9%) in demonstrating ossicular chain destruction.
Conclusion: It was determined that in patients who underwent tympanoplasty HRCT did not significantly change the surgical plan. One of the advantages of HRCT is preparation of prosthesis or bone cement preoperatively in patients with ossicular chain defect in HRCT. Radiologist with otolaryngologist giving decision to surgery together with the HRCT will ensure that the interpretation is optimal.
Keywords : Otitis media, Tympanoplasty, Tomography