Kronik Otitis Medialı Hastalarda Cerrahi Öncesi Temporal Kemik Bilgisayarlı Tomografi Bulguları İle İntraoperatif Bulguların Karşılaştırılması

Abstract

Habib H. The correlation of Preoperative Temporal Bone Computed Tomography Findings with Intraoperative Findings In Chronic Otitis Media Patients. Hacettepe University Faculty Of Medicine ENT Department, Speciality Thesis, Ankara 2019. Computed tomography (CT) has a very importent place for the evaluation of the anatomical structures, the localization of pathology and spread of the disease, the determination of extent of erosion in order to predict possible complications. The aim of our study is to compare the findings of temporal bone CT with intraoperatively observed pathological findings and to assess the value of temporal bone CT in preoperative evaluation, diagnosis and prediction of complications of chronic otitis media surgery therefore to determine its value in preoperative surgical planning. A group of 261 patients who were operated between 2012 and 2016 and have preoperative temporal bone CT were included in the study. Parameters evaluated both on CT and during surgery were malleus, incus, stapes, facial canal, LSC and middle ear status. The images (CT) were evaluated by a single radiologist who is experienced on temporal bone radiology and blinded to the surgical results. The results were compared with the surgical findings and the correct classification number, concordance and correlation of CT were determined. Correlation of findings regarding malleus was found to be CCN: 79.3%, Kappa: 35.2% (moderate compliance), Cramer V: 35.2% (low level correlation) (p <0.001). For incus, the CCN: 77.8%, kappa: 57.3% (moderate compliance), Cramer V: 54.7% (moderate correlation) (p <0.001), for facial canal, CCN: 89.6%, Kappa: 46% (moderate compliance), Cramer V: 44.8% (moderate correlation) (p <0.001). For middle ear status, CCN: 46%, Kappa: 26.8% (low compliance), Cramer V: 39% (low & poor correlation) (p <0.001). For stapes,specificity was 89%, sensitivity was 86%, NPV: 97%, PPV: 62%, Kappa: 66.1% (good compliance), Phi: 67.4% (moderate correlation) (p <0.001). For incudostapedial joint, specificity was 90.3%, sensitivity: 75.5, NPV: 84.3%, PPV: 84.2%, Kappa: 66.1% (good compliance), Phi: 67.2% (moderately correlated) (p <0.001). For LSC specificity: 98.8%, sensitivity: 83.3, NPV: 99.6%, PPV: 62%, Kappa: 70.7% (good level of compliance), Phi: 71.4% (strong correlation). As a result, there was a low level of correlation and compliance between the radiological and surgical findings of malleus and middle ear while there was a moderate correlation and compliance for incus and facial canal. There was a good compliance regarding stapes and incodustapedial joint but a moderate correlation. There was only good compliance and strong correlation for LSC erosion.