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高分辨率计算机断层扫描颞骨在确定安全型和局限性鳞状上皮型慢性化脓性中耳炎病例中的听小骨侵蚀方面的效果如何?

How Efficacious is HRCT Temporal Bone in Determining the Ossicular Erosion in Cases of Safe and Limited Squamous Type CSOM?

作者信息

Singh Jaskaran, Bhardwaj Bhanu

机构信息

SGRD Institute of Medical Sciences and Research, Amritsar, HIG 202; Sector 71, Mohali, Punjab 160071 India.

SGRD Institute of Medical Sciences and Research, Amritsar, 27-C Sant Avenue, The Mall, Amritsar, Punjab 143001 India.

出版信息

Indian J Otolaryngol Head Neck Surg. 2019 Nov;71(Suppl 2):1179-1182. doi: 10.1007/s12070-018-1250-6. Epub 2018 Feb 17.

Abstract

HRCT temporal bone is a very valuable radiological investigation. However its still not widely used by otologists for routine surgeries. Ossicular erosion is often encountered unexpectedly in safe cases of CSOM and in limited squamous type of cases. If preoperative diagnosis of ossicular erosion is made then otologist can preoperatively plan ossicular reconstruction techniques leading to improved results. We conducted a study in 60 patients to evaluate the efficacy of HRCT temporal bone in determining ossicular erosion in cases of CSOM. It was a diagnostic observational study where surgical finding of ossicular erosion was taken as a gold standard. Sensitivity specificity; positive predictive value and negative predictive value of HRCT was calculated in detecting malleus; incus and stapes erosion. value was calculated. Sensitivity and specificity for malleus erosion was 78.5% and 78.1% respectively. Sensitivity and specificity for incus erosion was 73.1% and 57.8% respectively. Sensitivity and specificity for stapes erosion was 52% and 57.1% respectively. value was less than 0.05. We concluded that HRCT is a good adjunct for determining the ossicular erosion and its use should be encouraged by the otologist.

摘要

颞骨高分辨率计算机断层扫描(HRCT)是一项非常有价值的影像学检查。然而,它在耳科医生的常规手术中仍未得到广泛应用。在慢性化脓性中耳炎(CSOM)的安全病例以及有限的鳞状类型病例中,常常会意外发现听小骨侵蚀。如果能在术前诊断出听小骨侵蚀,那么耳科医生就可以在术前规划听小骨重建技术,从而提高手术效果。我们对60例患者进行了一项研究,以评估颞骨HRCT在确定CSOM病例中听小骨侵蚀方面的有效性。这是一项诊断性观察研究,将听小骨侵蚀的手术发现作为金标准。计算了HRCT在检测锤骨、砧骨和镫骨侵蚀时的敏感性、特异性、阳性预测值和阴性预测值。计算了相关值。锤骨侵蚀的敏感性和特异性分别为78.5%和78.1%。砧骨侵蚀的敏感性和特异性分别为73.1%和57.8%。镫骨侵蚀的敏感性和特异性分别为52%和57.1%。相关值小于0.05。我们得出结论,HRCT是确定听小骨侵蚀的良好辅助手段,耳科医生应鼓励使用。

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