abstract nr.: O081

HIGH RESOLUTION COMPUTERIZED TOMOGRPAHY (HRCT) GUIDED FLEXIBLE CHOLESTEATOMA SURGERY : OUR EXPERIENCE
Author: N.B. Prahlada, Karnataka ENT Institute & Research Centr, Chitradurga, India
Co-author(s): R. Diwakar, Basaveshwara Medical College, Chitradurga, India
Topic: Imaging
Keywords: HRCT, Flexible mastoidectomy, Cholesteatoma complications, Cholesteatoma
 
OBJECTIVES : The value of HRCT prior to routine mastoid surgery for cholesteatoma remains controversial. Modern imaging reliably demonstrates surgical anatomy, dictating the ideal approach, forewarns of complications and reveal the extent of disease. This prospective study looks at the influence of pre-operative scanning on the surgical management of Cholesteatoma.

METHODS : 66 patients who underwent various surgeries for cholesteatoma were considered. All patients underwent HRCT prior to surgery. Patients were classified into various groups depending on the extent of the disease, involvement of the ossicles and presence of potential complications demonstrated by the HRCT. Various mastoid surgeries were adopted for each group. Postoperatively patients were regularly followed with Otomicroscopy, Oto-endoscopy of mastoid cavity and when required HRCT.

RESULTS : HRCT was highly sensitive and specific in assessing the extent of the disease, bone destruction, and involvement of the ossicles and presence of complications such as sinus and intracranial extension. However, CT was less helpful in identifying facial nerve dehiscence. HRCT was of great help in planning ossiculoplasty and cavity obliteration procedures.

CONCLUSIONS : There is slight resistance among Otologists to adapt preoperative CT Scanning prior to cholesteatoma surgery. The radiological findings not only determine the choice of surgical approach, but also predicted potential hazards. CT can guide an Otologist as a road map for cholesteatoma and help in planning flexible surgical technique and identifying potential complications.


 
Presentation preference: