Otitis Media With Cholesteatoma Multislice Ct Preoperative Evaluation And Intraoperative Findings Comparative Study

[Objective] Through comparative analysis for diagnostic accordant rate between MSCT(multi-slice spiral CT) imaging diagnosis of preoperative treatment and mid-operation finding, to explore the diagnostic value of MSCT to pathological changes of otitis media with cholesteatoma and to provide reference standard for the selection of surgical approach, route and prognosis.[Methods] According to diagnostic criteria, the intact data from 71 patients of chronic otitis media with cholesteatoma were enrolled. These patients were from inpatients of the department of otolaryngology of the first affiliated hospital of Kunming Medical College from August,2008 to October,2009. The patients were preoperatively diagnosed by MSCT and confirmed to cholesteatoma by postoperatively pathologic examination. According to each patient's temporal bone MSCT imaging data, deliberately study the locations of cholesteatoma existed, the broken situations of ossicular chain and the invaded degree of the middle ear adjacent bone, etc., then compared the diagnosis of preoperative treatment and mid-operation finding to analyse the diagnostic accordant rate between them.[Results] Confirmed by the correlation of pre-operative MSCT diagnosis and surgically histopathological findings:preoperative CT diagnosis of cholesteatoma filling positions was 128, but confirmed by post-operation was 124, the diagnostic accordant rate was 93.5%; preoperative CT diagnosis of ossicular chain damage was 183, but confirmed by post-operation was 167, the diagnostic accordant rate was 88%; preoperative CT diagnosis of middle ear adjacent to the site of bone invasion was 147. but confirmed by post-operation was 135, the diagnostic accordant rate was 91.9%.[Conclusion] For diagnosis of otitis media with cholesteatoma, MSCT imaging diagnosis is basically the same to the finding of ear surgery under the microscope, it has a role in diagnosis of the otitis media with cholesteatoma and especially about the position of soft-density focus and the location/extent of bony-erosion, and the situation of ossicles-erosion, which is a reliable diagnostic method. These findings would alert the clinician to the possibility of cholesteatoma, which will guide in the surgical approach and treatment plan.