The Role of Preoperative Computed Tomography of Temporal Bone in Atticotomy as a New Tool for Determining the Approach

  • Ahmed Abdelrahman AbdelazizEmail author
Original Article


The temporal bone is a complex anatomical structure and so preoperatively computed tomography (CT) of the temporal bone is important for choice of the surgical procedure. In this study, evaluation of the surgical difficulty to conduct transmastoid atticotomy with the coronary cut of CT temporal bone. Additional, attic pathology intraoperative is evaluated. The current research is a retrospective study of 79 patients with chronic suppurative otitis media (safe type) with the preoperative opacity of the attic in CT temporal bone. The researcher correlates difficulty to do transmastoid attictomy with the distance in mm between the roof of external audiatory canal (EAC) and tegmen with ruler directly in the coronary cut of CT temporal bone at the the level of internal auditory canal (IAC). The researcher also compares attic pathology intraoperative with preoperative CT attic opacity. In group of surgically difficulty average distance between the superior wall of EAC and tegmen on preoperative CT at the level of IAC is 2–5 mm while distance in easily surgical approach is from 6 to 10 mm. 68.4%(54/79) of cases had pathology in attic in the form of granulation tissue in 50 cases and glue in 4 cases. Preoperative CT temporal bone is very important to detect atticotomy approach either transmastoid or transcanal, through measuring the distance in mm between the roof of EAC and tegmen with ruler directly in the coronal cut of CT temporal bone at the level of internal auditory canal. The opacity of the attic in Preoperative CT does not mean that there is a pathology in the attic.


Attic CT temporal bone Atticotomy 


Compliance with Ethical Standards

Conflict of interest

Authors declare that there was no conflict of interest.


  1. 1.
    Hashemi J, Rajati M, Rezayani L, Bahadori A (2014) Temporal bone measurements.a comparison between rendered spiral CT and surgery. Iran J Radiol 11(3):e9400CrossRefGoogle Scholar
  2. 2.
    Chatterjee P, Khanna S, Talukdar R (2015) Role of high resolution computed tomography of mastoids in planning surgery for chronic suppurative otitis media. Indian J Otolaryngol Head Neck Surg 67(3):275–280CrossRefGoogle Scholar
  3. 3.
    Yates PD, Flood LM, Banerjee A, Clifford K (2002) CT scanning of middle ear cholesteatoma. What does the surgeon want to know. Br J Radiol 75(898):847–852CrossRefGoogle Scholar
  4. 4.
    Keskin S, Cetin H, Tore HG (2011) The correlation of temporal bone CT with surgery findings in evaluation of chronic inflammatory disease of the middle ear. Eur J Gen Med 8(1):24–30CrossRefGoogle Scholar
  5. 5.
    Chrwa M, Mulwafu W, Aswani JM, Masinde PW, Mkakosya R, Soko D (2015) Microbiology of chronic suppurative otitis media at a cross-sectional descriptive study. Malawi Med J 27(4):120–124Google Scholar
  6. 6.
    Mahadevaiah A, Parikh B (2008) Modified intact canal wall mastoidectomy-long term results in hearing and healing. Indian J Otolaryngol Head Neck Surg 60:317–323CrossRefGoogle Scholar
  7. 7.
    Karaca CT, Toros SZ, Noseri HK (2012) Analysis of anatomic variation in temporal bone by radiology. Int Adv Otol 8(2):239–243Google Scholar
  8. 8.
    Gerami H, Nagbavi E, Mogbadam MW, Forgbanparast K, Akbar MH (2009) Comparison of preoperative computerized tomography scan imaging of temporal bone with intra-operative findings in patients undergoing mastoidectomy. Saudi Med J 30(1):104–108PubMedGoogle Scholar
  9. 9.
    Pereira AR, Diogenes JS, Vierradecastro JD, Filho JA, Freitas MR (2012) Matoidectomy: anatomical parameters x surgical difficulty. Int Arch Otorhinolaryngol 16(1):828Google Scholar
  10. 10.
    Lee DH, Jung MK, Yoo YH (2008) Analysis of unilateral sclerotic temporal bone :how does the sclerotic change the mastoid pneumatization morphologicall in the temporal bone. Surg Radiol Anat 30:221–227CrossRefGoogle Scholar
  11. 11.
    Tatlipinar A, Tuncel A, Redik EA, Eer T, Usulu C (2012) The role of computed tomography scanning in chronic otitis media. Eur Arch Otorhinolaryngol 269:33–38CrossRefGoogle Scholar

Copyright information

© Association of Otolaryngologists of India 2018

Authors and Affiliations

  1. 1.Minia University HospitalMiniaEgypt

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