Preoperative predictive criteria for mastoid extension in pars flaccida cholesteatoma in assessments using temporal bone high-resolution computed tomography

We aimed to clarify the usefulness of high-resolution computed tomography (HRCT) and establish HRCT criteria for presurgical assessment of the mastoid extension in pars flaccida cholesteatomas of the middle ear. Retrospective observational study. Patients who underwent primary surgery for pars flacc...

Full description

Saved in:
Bibliographic Details
Published in:Auris, nasus, larynx nasus, larynx, 2021-08, Vol.48 (4), p.609-614
Main Authors: Baba, Akira, Kurihara, Sho, Ogihara, Akira, Matsushima, Satoshi, Yamauchi, Hideomi, Ikeda, Koshi, Kurokawa, Ryo, Ota, Yoshiaki, Takahashi, Masahiro, Sakurai, Yuika, Motegi, Masaomi, Komori, Manabu, Yamamoto, Kazuhisa, Yamamoto, Yutaka, Kojima, Hiromi, Ojiri, Hiroya
Format: Article
Language:English
Subjects:
HRCT
Mastoid
Pars flaccida cholesteatoma
Preoperative
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:We aimed to clarify the usefulness of high-resolution computed tomography (HRCT) and establish HRCT criteria for presurgical assessment of the mastoid extension in pars flaccida cholesteatomas of the middle ear. Retrospective observational study. Patients who underwent primary surgery for pars flaccida cholesteatoma and those who underwent temporal bone HRCT for pretreatment evaluation were reviewed. The distance in the anterior-most portion of the mastoid sinus on HRCT was measured, and the presence of surgically verified mastoid extension of cholesteatoma was evaluated. All cases were subclassified as M+ (surgically mastoid extension-positive) or M- (surgically mastoid extension-negative). A total of 107 patients with pars flaccida cholesteatoma were included. The distance in the M+ cases was significantly longer than that in the M- cases, and the cutoff value was 3.6 mm. The difference between the ipsilateral/diseased-side distance and the contralateral/evaluable side (difference value) in M+ cases was larger than that in M- cases, with a cutoff value of 0.6 mm. The inter-rater reliability of this distance measurement was excellent, regardless of imaging experience. The cutoff values of the distance and the difference value can be used for pretreatment HRCT evaluation of mastoid extension in middle ear cholesteatoma with relatively high accuracy, regardless of the experience and skill levels of the evaluator.
ISSN:0385-8146
1879-1476
DOI:10.1016/j.anl.2020.11.014