Department of Otorhinolaryngology, AIIMS Patna, Patna, Bihar, 801507, India.
Department of Radiodiagnosis, AIIMS Patna, Patna, Bihar, India.
Eur Arch Otorhinolaryngol. 2024 Dec;281(12):6359-6365. doi: 10.1007/s00405-024-08872-x. Epub 2024 Aug 3.
Chronic otitis media with cholesteatoma is a frequent disease entity in otology, requiring surgery in overwhelming majority of cases. Despite the huge burden there is no established grading system available to assess the severity and extent of disease preoperatively until date. Aim of our study is to assess the applicability of ChOLE staging to preoperative HRCT temporal bone in Chronic otitis media with cholesteatoma.
Patients clinically diagnosed as COM with cholesteatoma, who underwent preoperative HRCT temporal bone imaging and mastoid exploration at our tertiary care centre were included. Preoperative radiology was assessed and a radiological ChOLE (r-ChOLE) was given by radiologist. This was then compared with the postop ChOLE.
21 patients were included in the study. Data was linear and normally distributed (Shapiro wilk test). Pearson's product-moment correlation used to see relationship between radiological and postop Total score showed strong statistically significant positive correlation with correlation coefficient (r) of 0.977. Paired t test showed p value was 0.329 (p > 0.05) suggesting no significant difference between radiological and postop Total scores. Cohen kappa test of agreement was applied. It revealed an overall strong agreement (p < 0.001).
ChOLE staging may be extended to preoperative HRCT of temporal bone in COM with cholesteatoma (rCHOLE). A preoperative radiological staging will help in better prioritizing, planning and execution of tympanomastoid surgeries.
胆脂瘤型慢性中耳炎是耳科学中常见的疾病实体，绝大多数情况下需要手术治疗。尽管负担沉重，但迄今为止，仍没有一种既定的分级系统可用于术前评估疾病的严重程度和范围。本研究旨在评估 ChOLE 分期在慢性中耳炎伴胆脂瘤术前高分辨率 CT（HRCT）颞骨中的适用性。
纳入在我们的三级护理中心接受术前 HRCT 颞骨成像和乳突探查的临床诊断为 COM 伴胆脂瘤的患者。由放射科医生评估术前影像学并给出放射科 ChOLE（r-ChOLE）评分，然后与术后 ChOLE 评分进行比较。
21 例患者纳入研究。数据呈线性和正态分布（Shapiro-Wilk 检验）。使用 Pearson 乘积矩相关系数来观察放射学和术后总评分之间的关系，发现两者之间具有很强的统计学显著正相关，相关系数（r）为 0.977。配对 t 检验显示 p 值为 0.329（p＞0.05），表明放射学和术后总评分之间无显著差异。应用 Cohen kappa 检验评估一致性。结果显示总体一致性较强（p＜0.001）。
ChOLE 分期可扩展至 COM 伴胆脂瘤的术前 HRCT 颞骨（rCHOLE）。术前放射学分期将有助于更好地确定、计划和执行鼓室乳突手术的优先级。
