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Year: 2022  Vol. 26   Num. 3  - Julyy/Sept
DOI: 10.1055/s-0041-1736580
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Original Article
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Are Hounsfield Unit Measurements of Bony Absorption Changes in Cholesteatoma Helpful?
Author(s):
Shay Shemesh, Judith Luckman, Tal Marom, Oded Kraus, Sharon Ovnat Tamir
Key words:
computed tomography - Hounsfield unit - cholesteatoma - ossicles
Abstract:

Introduction High-resolution computed tomography (HRCT) scans of the temporal bone are used to assess the bony erosion of the middle-ear structures whenever cholesteatoma is suspected.

Objective To study the differences in HRCT Hounsfield unit (HU) index measurements of middle-ear bony structures between an ears with and without cholesteatoma.

Methods A retrospective study of 59 patients who underwent surgery due to unilateral cholesteatoma. The HRCT HU index of the scutum, of three middle-ear ossicles, of the lateral semicircular canal (LSCC), and of the fallopian canal was measured in both ears. A comparison was made between the cholesteatoma and the non-cholesteatomatous ear (control). All measurements were conducted by an otolaryngologist. To assess the interobserver bias, 10% of the samples were randomly and independently assessed by another otolaryngologist and a neuroradiologist who were blinded.

Results The average HU index was lower in the ear with cholesteatoma when compared with the non-cholesteatomatous ear. While the differences were statistically significant regarding the measurements of the scutum (516.02  311.693 versus 855.64  389.999; p = 0.001), the malleus (1049.44  481.765 versus 1413.47  313.376; p = 0.01), and the incus (498.03  264.184 versus 714.25  405.631; p = 0.001), the differences in the measurements of the LSCC (1042.34  301.066 versus 1154.53  359.609; p = 0.69) and of the fallopian canal (467.19  221.556 versus 543.51  263.573; p = 0.108) were not significantly different between both groups. The stapes was immeasurable in both groups due to its small size.

Conclusion Hounsfield unit index measurements are a useful tool that may aid in the diagnosis of early-stage cholesteatoma.

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