Why Do We Not Need CT in Patients Who Undergo Type I Tympanoplasty?

Objective: High-resolution computed tomography (HRCT) has gained wide acceptance in diagnostic work- up of suppurative chronic otitis media. Most ear surgeons order HRCT to make a rational operative plan, especially in the presence of symptoms, such as refractory otorrhea with bad odor, epithelial debris at retraction pockets, and defects in bony walls of the middle ear. The aim of this study was to show the lack of necessity of preoperative HRCT by evaluating its predictive value in patients who underwent type I tympanoplasty. Methods: The study included a patient group who underwent tympanoplasty with dry perforation and normal middle ear mucosa. The intraoperative findings of 43 patients were compared with preoperative HRCT and audiogram findings. Results: There was no significance between preoperative air conduction threshold and existence of ossicular erosion in HRCT. HRCT incorrectly predicted the presence of cholesteatoma in two patients. The positive predictive value of HRCT in detecting soft or granulation tissue was 4/14 (28.57%). The sensitivity and specificity of HRCT in the diagnosis of ossicular chain status were 9.09% and 90.62%, respectively. Conclusion: HRCT plays an important role in the assessment of patients with suppurative chronic otitis media and cholesteatoma. However, preoperative HRCT in patients who have undergone type I tympanoplasty is not necessary. It has no benefit and also leads patients to unnecessary radiation exposure.