title: Comparison of Conventional Versus Spiral Computed Tomography with Three Dimensional Reconstruction in Chronic Otitis Media with Ossicular Chain Destruction.
abstract: BACKGROUND
  Chronic otitis media (COM) can be treated with tympanoplasty with or without mastoidectomy. In patients who have undergone middle ear surgery, three-dimensional spiral computed tomography (CT) scan plays an important role in optimizing surgical planning.
  
  
  OBJECTIVE
  This study was performed to compare the findings of three-dimensional reconstructed spiral and conventional CT scan of ossicular chain study in patients with COM.
  
  
  METHODS
  Fifty patients enrolled in the study underwent plane and three dimensional CT scan (PHILIPS-MX 8000). Ossicles changes, mastoid cavity, tympanic cavity, and presence of cholesteatoma were evaluated. Results of the two methods were then compared and interpreted by a radiologist, recorded in questionnaires, and analyzed. Logistic regression test and Kappa coefficient of agreement were used for statistical analyses.
  
  
  RESULTS
  Sixty two ears with COM were found in physical examination. A significant difference was observed between the findings of the two methods in ossicle erosion (11.3% in conventional CT vs. 37.1% in spiral CT, P = 0.0001), decrease of mastoid air cells (82.3% in conventional CT vs. 93.5% in spiral CT, P = 0.001), and tympanic cavity opacity (12.9% in conventional CT vs. 40.3% in spiral CT, P=0.0001). No significant difference was observed between the findings of the two methods in ossicle destruction (6.5% conventional CT vs. 56.4% in spiral CT, P = 0.125), and presence of cholesteatoma (3.2% in conventional CT vs. 42% in spiral CT, P = 0.172). In this study, spiral CT scan demonstrated ossicle dislocation in 9.6%, decrease of mastoid air cells in 4.8%, and decrease of volume in the tympanic cavity in 1.6%; whereas, none of these findings were reported in the patients' conventional CT scans.
  
  
  CONCLUSIONS
  Spiral-CT scan is superior to conventional CT in the diagnosis of lesions in COM before operation. It can be used for detailed evaluation of ossicular chain in such patients.
authors.affiliation: Department of Radiology, Faculty of Medicine, Mashhad Branch, Islamic Azad University, Mashhad, Iran.
authors.forename: Saeed
authors.initials: S
authors.lastname: Naghibi
authors.affiliation: Department of Radiology, Faculty of Medicine, Mashhad Branch, Islamic Azad University, Mashhad, Iran.
authors.forename: Sirous
authors.initials: S
authors.lastname: Seifirad
authors.affiliation: Department of Radiology, Faculty of Medicine, Mashhad Branch, Islamic Azad University, Mashhad, Iran.
authors.forename: Mahboobeh
authors.initials: M
authors.lastname: Adami Dehkordi
authors.affiliation: Department of Radiology, Faculty of Medicine, Mashhad Branch, Islamic Azad University, Mashhad, Iran.
authors.forename: Sasan
authors.initials: S
authors.lastname: Einolghozati
authors.affiliation: Department of Radiology, Faculty of Medicine, Mashhad Branch, Islamic Azad University, Mashhad, Iran.
authors.forename: Nafiseh
authors.initials: N
authors.lastname: Ghaffarian Eidgahi Moghadam
authors.affiliation: Department of Radiology, Mashhad University of Medical Sciences, Mashhad, Iran.
authors.forename: Amir
authors.initials: A
authors.lastname: Akhavan Rezayat
authors.affiliation: Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Soroush
authors.initials: S
authors.lastname: Seifirad
keywords: Cholesteatoma; Otitis Media; Spiral Computed; Tomography