Rocher P, Carlier R, Attal P, Doyon D, Bobin S
Service d'ORL et Chirurgie cervico-faciale, CHU Bicêtre, Kremlin-Bicêtre.
Ann Otolaryngol Chir Cervicofac. 1995;112(7):317-23.
High resolution computed tomography (CT) is today the best imaging to study chronic middle ear diseases. In a retrospective analysis of 85 chronic otitis media (cholesteatoma or not), the authors emphazise the diagnostic value of CT scan, its preoperative's role and the radiologic imaging of cholesteatoma. In our study, the radiosurgical correlation rate is 0.6 regarding positive diagnosis in chronic otitis or cholesteatoma. The malleus and incus analysis is correct, but stapes is not observed in 40% of cholesteatoma. The correlation of surgical and radiographic findings is excellent regarding the scutum, the horizontal semicircular canal (> 0.7), the tegmen (= 0.6), bad for the canal of facial nerve (< 0.5). The actual extent of chronic otitis media lesions is overestimated by CT scan in 70% of cases. The correlation's rate is reliable for epitympanum and aditus. To conclude, the preoperative CT is necessary in those cases: closed eardrum cholesteatoma, single functional ear, clinical complications and doubtful diagnosis.
高分辨率计算机断层扫描(CT)如今是研究慢性中耳疾病的最佳影像学检查方法。在一项对85例慢性中耳炎(无论是否伴有胆脂瘤)的回顾性分析中,作者强调了CT扫描的诊断价值、其术前作用以及胆脂瘤的放射影像学表现。在我们的研究中,对于慢性中耳炎或胆脂瘤的阳性诊断,放射外科关联率为0.6。锤骨和砧骨分析正确,但在40%的胆脂瘤病例中未观察到镫骨。关于盾板、水平半规管(>0.7)、鼓室盖(=0.6),手术和影像学检查结果的相关性良好,而对于面神经管则较差(<0.5)。在70%的病例中,CT扫描高估了慢性中耳病变的实际范围。对于上鼓室和鼓窦入口,关联率可靠。总之,在以下病例中术前CT检查是必要的:鼓膜封闭性胆脂瘤、单耳功能性耳、临床并发症以及诊断存疑的情况。