Analysis of correlation of intraoperative findings and preoperativ imaging of anatomic landmarks of lateral skull base in chronic ear diseases

Introduction:

Imaging of lateral skull base before operation is daily routine and recommended by current guidelines. Nevertheless, precision and relevance of visualization of dedicated structures of the lateral skull base under pathological conditions is still under discussion.

Methods:

Results of preoperative imaging of 85 patients by CBCT were compared to intraoperative findings. Imaging was performed in clinical suspicion of chronic otitis media adhesive or meso-/epitympanalis. 79 different anatomic and radiological parameters were analyzed.

Results:

In most of the structures (e.g. bony skull base, semicircular canals, long process of incus) a significant correlation of imaging and intra-op findings was detected (p < 0.01). Only in visualisation of incu-stapedial joint, the parts of the stapes and the tympanic part of facial nerve, a low or no correlation could be found. Subgroups analysis of different pathologies showed most impairments in cholesteatoma. In patients with chronic otitis media mesotympanalis only the visualisation of the ear drum was limited.

Conclusion:

CBCT realizes a sufficient visualization of relevant anatomic bony structures of lateral skull base. Regarding the stapes, significant limits exist and a sufficient differentiation of underlying pathology, bony destruction and anatomic variant is still not possible.

Publication History

Publication Date:
18 April 2018 (online)