만성 중이염의 골 결손에 대한 고해상도 측두골 전산화단층촬영의 진단적 유용성

Background and Objectives: High resolution computed tomography (HRCT) of the temporal bone is much useful tool for detecting microstructure of the inner and middle ear. The purpose of this study was to investigate diagnostic significance for bony defect of the facial nerve canal, the tegmen tympani and the lateral semicircular canal between the findings of HRCT and the operative findings in chronic otitis media. Material and Method: Ninety seven patients with chronic otitis media that had undergone preoperative HRCT were reviewed retrospectively. All the patients had also undergone tympanoplasty with canal wall down mastoidectomy from March 2003 to January 2006. Results: The sensitivity, specificity and predictability for bony defect of the facial nerve canal were 78.8%, 93.8% and 88.7%, and for bony defect of the tegmen tympani were 90.0%, 95.4% and 94.9%, and for bony defect of the lateral semicircular canal were all 100.0%. In addition, the bony defect of facial nerve canal, tegmen tympani and lateral semicircular canal were significant correlation between the preoperative HRCT findings and the operative findings (p<0.05). Conclusions: The results of this study suggest that HRCT is an effective diagnostic tool for bony defect in chronic otitis media. Therefore, HRCT can be quite instrumental in planning a surgical treatment and reducing the iatrogenic complications on the middle ear surgery. (J Clinical Otolaryngol 2008;19:183-188)