Assessment of of pre-operative high-resolution computed tomography and intra-operative findings in cholesteatoma patients: A retrospective study

Abstract

Abstract Background- Cholesteatoma is a non-neoplastic locally aggressive lesion that commonly occurs within the pneumatized temporal bone that often necessitates surgical intervention due to its potential to cause complications such as hearing loss, dizziness, fascial nerve paralysis. High resolution computed tomography (HRCT) aids in its assessment, guiding surgical planning. This study aim was to evaluate the diagnostic efficacy of HRCT compared to surgical findings at St. Paul’s Hospital Millennium Medical College (SPHMMC). Objectives: The aim of this study was to synthesize knowledge on pre-operative high-resolution computed tomography (HRCT) scans in delineating the condition of middle ear structures in our patients diagnosed with cholesteatoma through a retrospective chart review from January 2023 to May 2024 Methods: This study involved a retrospective review of 42 high-resolution computed tomography (HRCT) reports, interpreted by senior radiologists, from January 2023 to May 2024 at St. Paul’s Hospital Millennium Medical College in Addis Ababa, Ethiopia. The HRCT findings of the temporal bone were compared with intraoperative findings from surgeries for cholesteatoma. Agreement between HRCT and surgical findings was assessed using Cohen's kappa statistic to measure beyond chance agreement. Sensitivity, specificity, positive predictive value, and negative predictive value of HRCT in detecting cholesteatoma were calculated relative to the surgical findings, which served as the gold standard. Results: The study included 42 cholesteatoma patients, aged 14 to 60 years, with a mean age of 30.1 years. The findings demonstrated an excellent correlation between preoperative high resolution computed tomography (HRCT) scans and intraoperative observations. Consequently, HRCT of the temporal bone is a valuable tool for surgeons in the early detection and surgical planning of cholesteatoma, despite its drawbacks of increased radiation exposure and relatively high cost. Key word-Cholesteatoma, Temporal HRCT, Surgery, Retrospective Chart Review, Validation Study