Usefulness of computed tomography Hounsfield unit density in preoperative detection of cholesteatoma in mastoid ad antrum.
OBJECTIVE
This study was performed to evaluate the usefulness of Hounsfield unit (HU) to better distinguish cholesteatoma from other inflammatory conditions in the mastoid ad antrum before primary mastoid surgery.


METHODS
We enrolled 82 patients who underwent tympanomastoidectomy for treatment of chronic otitis. Forty-one patients were pathologically diagnosed with cholesteatoma, whereas the others were diagnosed with inflammatory granulation. These lesions were confirmed, and HU was measured in preoperative computed tomography. The difference in HU between cholesteatoma and non-cholesteatoma tissues was analyzed, and the improvement in the diagnosis of cholesteatoma after inclusion of HU data was calculated.


RESULTS
The HU was calculated as 42.68 ± 24.42 in the cholesteatoma group and 86.07 ± 26.50 in the non-cholesteatoma group. The differences between the 2 groups were statistically different (Student t test, P < .01). By applying the HU, the sensitivity (51.2%-80.5%), specificity (80.5%-87.8%), positive predictive value (72.4%-86.8%), and negative predictive value (62.3%-81.8%) to diagnose cholesteatoma improved.


CONCLUSIONS
The HU density was found to be statistically different between cholesteatoma and inflammatory granulation tissue in mastoid antrum. An improved diagnosis of cholesteatoma was achieved after adjusting for the HU.
Park
Min-Hyun
MH
Department of Otorhinolaryngology, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul, South Korea. drpark@snu.ac.kr
Rah
Yoon Chan
YC
Kim
Young Ho
YH
Kim
Ji-Hoon
JH
D000328:Adult; D018424:Cholesteatoma, Middle Ear / Q000000981:diagnostic imaging* / Q000601:surgery*; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008297:Male; D008416:Mastoid / Q000000981:diagnostic imaging* / Q000601:surgery; D008875:Middle Aged; D016017:Odds Ratio; D011237:Predictive Value of Tests; D011300:Preoperative Care / Q000379:methods*; D012189:Retrospective Studies; D036542:Tomography, Spiral Computed / Q000379:methods*