Findings in CSOM: Our Experience in Sudanese Population-A CT based Study

Zuhal Y. Hamd, C. Ayad, M. E. Supervisor
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Abstract

Chronic suppurative otitis media (CSOM) is one of the leading causes of hearing impairment in developing countries. Objectives: are to highlight the high resolution computerized tomography (HRCT) temporal bone findings in chronic middle ear infections with reference to it ’ s extent and complications, as well, the presented common signs, symptoms and the duration impact on the anatomical structures and pathological changes in each part and for both sides. Materials and Methods: Preliminary clinical assessment was obtained for 114 patients diagnosed with CSOM, and then they were referred for a HRCT of temporal bone which was done using multi-detector CT scanner. Results: Of the 114 patients; 63(55.3%) were males and 51(44.7%) were females: Otorrhoea is the most common symptom, and was found in 113 patients constituting (99.1%) followed by Otolegia 69(60.5%) and headache affected 53(46.5%) of the cases. CSOM is more common in low socio-economic status .In ears affected with CSOM, the maximum CT number (Hounsfield) was found to be changed and was significantly affected with increasing patients’ age. Sclerotic changes and soft tissue density increased as the duration of CSOM increased in right and left middle ears significantly (F=5.802, Sig at 0.000), and (F=23.182, Sig at .015) respectively. Partial and complete erosion were detected in both right and left ossicle in the advanced phase of disease, where the ossicle still intact in the early stage , and the correlation is found to be significant with increasing of CSOM duration (F=16.959, Sig 0.000) and (F= 3.673, Sig =0.036)for right and left ossicles respectively. Changes including total and partial opacification, sclerotic changes, soft tissue density, mucosal thickening were the findings detected in both right and left mastoid in HRCT for temporal bone scanning. Conclusions: HRCT of temporal bone is useful in identifying various findings related to the location and extent of disease.
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CSOM的发现:我们在苏丹人口中的经验——一项基于CT的研究
慢性化脓性中耳炎(CSOM)是发展中国家听力损害的主要原因之一。目的:探讨慢性中耳感染的颞骨高分辨率计算机断层扫描(HRCT)表现,包括其程度、并发症、常见体征、症状及持续时间对各部位及双侧解剖结构和病理改变的影响。材料与方法:对114例确诊为CSOM的患者进行初步临床评估,并转介行颞骨HRCT,采用多探头CT扫描。结果:114例患者中;男性63例(55.3%),女性51例(44.7%),其中以耳漏最为常见,113例(99.1%),其次为耳鸣69例(60.5%),头痛53例(46.5%)。CSOM多见于社会经济地位较低的人群。在患CSOM的耳朵中,最大CT数(Hounsfield)随着患者年龄的增加而改变,并受到显著影响。随着CSOM持续时间的延长,右中耳和左中耳的硬化变化和软组织密度显著增加(F=5.802, Sig = 0.000), F=23.182, Sig = 0.015)。疾病晚期左右听骨均可见部分和完全糜蚀,早期听骨完好,且与CSOM持续时间的增加相关(F=16.959, Sig 0.000),与左右听骨的相关性显著(F= 3.673, Sig =0.036)。颞骨HRCT扫描右、左乳突均可见完全或部分浑浊、硬化改变、软组织密度、粘膜增厚等变化。结论:颞骨HRCT在识别与疾病位置和程度相关的各种表现方面是有用的。
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