Wilkinson Sophie L, Sahota Raguwinder S, Constable James D, Harper Frazer, Judd Owen
Ear, Nose and Throat Department, Derby Teaching Hospitals NHS Foundation Trust, Derby, United Kingdom.
Laryngoscope. 2017 Dec;127(12):2860-2865. doi: 10.1002/lary.26594. Epub 2017 Apr 11.
The prevalence of incidental temporal bone disease on magnetic resonance imaging has been widely reported in the medical literature. Despite this, there currently is little evidence regarding incidental otological disease on computerized tomography (CT). Thus, the study aimed to review the CT prevalence of asymptomatic adult ear disease and evaluate the appropriateness of ear, nose, and throat (ENT) referral following its discovery.
Retrospective observational study of 468 CT scans.
All CT head scans performed between January 2015 and January 2016 containing the keyword mastoid in the radiological report initially were recruited for the study. Scans performed in the pediatric population following head trauma or for otological indications were excluded, leaving 468 eligible radiological images. The presence of prior otological disease or referral subsequently was established using electronic patient records.
Mastoid and/or middle ear opacification was noted to be present in 62 patients (13%). Of these patients, 10 subsequently were found to have prior otological intervention or review. Following exclusion of these patients, the rate of incidental temporal bone disease was recorded as 11%.
Data from this study suggests that incidental findings in an asymptomatic individual do not necessitate referral or further intervention. Furthermore, it is the author's recommendation that radiological findings be closely correlated with clinical examination to reduce false diagnosis and inappropriate referral to ENT.
医学文献中已广泛报道了磁共振成像上偶然发现的颞骨疾病的患病率。尽管如此，目前关于计算机断层扫描（CT）上偶然发现的耳科疾病的证据很少。因此，本研究旨在回顾无症状成人耳部疾病的CT患病率，并评估发现该疾病后耳鼻喉科（ENT）转诊的适宜性。
对468例CT扫描进行回顾性观察研究。
最初招募了2015年1月至2016年1月期间进行的所有CT头部扫描，这些扫描的放射学报告中包含关键词“乳突”。排除因头部外伤或耳科指征在儿科人群中进行的扫描，留下468份符合条件的放射学图像。使用电子病历确定是否存在既往耳科疾病或随后的转诊情况。
62例患者（13%）被发现有乳突和/或中耳混浊。在这些患者中，随后发现有10例曾接受过耳科干预或检查。排除这些患者后，偶然发现的颞骨疾病发生率记录为11%。
本研究数据表明，无症状个体的偶然发现不一定需要转诊或进一步干预。此外，作者建议将放射学检查结果与临床检查密切相关联，以减少误诊和不适当的耳鼻喉科转诊。
4。《喉镜》，127:2860 - 2865，2017年。
