J Korean Radiol Soc.  1990 Aug;26(4):704-712. 10.3348/jkrs.1990.26.4.704.

HRCT diagnosis in the evaluation of chronic middle ear inflammation

• Yu JS
• Kim DI
• Suh JH
• Chung TS

• KMID: 2359483
• DOI: http://doi.org/10.3348/jkrs.1990.26.4.704

Abstract

Through the preoperative high-resolution computed tomographic(HRCT) evaluation of the patietns with chronicmeddle ear inflammation, the nature and potential complications of the lesion can be evaluated more accuratelythan previous imaging modalities. We retrospectively reviewed the HRCT findings fo chronic middle ear inflammationin 50 surgically proven caes during recent 2 yeaars. We also compared findings of HRCT and otlogic surgery i orderto know the diagnostic ability of HRCT about the true nature and extent of soft tissue inflammatory masses within the middle ear and various complications. The results obtained were as follows: 1. HRCT domonstrated the softtissue inflammatory lesion in the middle ear cavity in all 50 cases. Among these, 32 cases were confirmed to have cholesteatoma, and 13 cases of granulations tissue including 2 cases of cholestraol granuloma, 3 cases ofthickened mucosa and 3 cases of inflammatory exude were verified respectively. 2. Among the 32 cases of cholesteatoma, HRCT showed the ossicular erosion in 87% and other complications in 38% of cases. The types ofcholelsteatoma can be predicted according to the site and extension of soft tissue mass except in 6 cases. 3. Among the 12 cases of granulation tissue, HRCT also showed the erosion of ossicles in 50% and facial nerve canalin 17%. 4. Pars flaccida type cholesteatomas(21 cases) we almost frequently noted in atticoantral area(67%) andpars tensa type(4 cases) in mesotympanum(75%). 5. Incus body and malleus head were the most vulnerable portions ofbony erosion in pars flaccida type(10/21). 6. We met some difficulty in differentiation of the soft tissue inflammatory mass in 7 cases. 6 cases of ossicular erosion and 3 cases of other complications were also misinterpreted mainly due to anatomic variations and technical factors of HRCT.

MeSH Terms

Cholesteatoma
Diagnosis*
Ear, Middle*
Facial Nerve
Granulation Tissue
Granuloma
Head
Incus
Malleus
Mucous Membrane
Otitis
Otitis Media*
Retrospective Studies