Temporal bone CT-scan prior to Eustachian Tube balloon dilatation - does it impact surgery indication?

Introduction The diagnosis of Eustachian tube dysfunction is based on a combination of clinical symptoms and apparative diagnostics. Eustachian tube balloon dilatation consists a commonly used treatment method for obstructive dysfunction. Temporal bone CT-scan is often used in the preoperative setting, although evidence for its diagnostic benefit isn’t adequate. Additionally, X-ray hazard and medical economics aspects force us to think critical about the role of CT-scan as a standardized, preoperative evaluation method and decision making tool.

Method A retrospective data analysis of preoperative temporal bone CT-scans for Eustachian tube dysfunction identified 144 cases, which were acquired between 2017 and 2019. The diagnostic importance of comutertomography was evaluated and accidental radiologic findings were defined. Furthermore, the diagnosis or indication change rate was examined.

Results Preliminary results show that in 17 % of cases (25/144) the CT-scan enriches or even changes the diagnosis. Most common radiological findings are mucosa swelling in paranasal sinuses and opacification of mastoid cells. Tumors are rare.

Discussion Temporal CT scan is a fast and widely available method to visualize the Eustachian tube and the adjacent structures. Nevertheless the benefit-risk ratio and medical economic aspects have to be taken in account individually when ordering temporal CT-scan for the diagnostic setting.

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Publication History

Article published online:
10 June 2020