Comparing Findings of Preoperative Computerized Tomography of the Petromastoid Region with Intraoperative Finding in Cases with Chronic Suppurative Otitis Media (CSOM)

Abstract

Objective: To compare the preoperative computerized tomography of petromastoid region with intraoperative finding in cases with chronic suppurative otitis media (CSOM). Study Design: Comparative cross-sectional study. Place and Duration of Study: Department of Otorhinolaryngology, Combined Military Hospital Gujranwala, Pakistan, from Jul to Dec 2024. Results: High-Resolution Computed Tomography (HRCT) findings were compared with intraoperative results in 70 patients. Ossicular erosion was detected in 37 cases by HRCT, with 33 confirmed (sensitivity 64.7%, specificity 78.9%, p=0.001). Bone erosion was noted in 40 cases, with 28 true positives (sensitivity 84.8%, specificity 67.6%). Tegmen erosion had 100% sensitivity but 0% specificity. Detection accuracy for scutum, facial canal, and sinus plate erosion varied (sensitivity 44%–50%, specificity 42.9%–100%). Conclusion: Retraction pockets seen on otoscopy are the most common sign of potentially dangerous CSOM (primary acquired cholesteatoma). HRCT has enhanced the preoperative detection of advanced disease and complications. However, it remains imperfect, with both false-positive and false-negative findings limiting its reliability.