UTILITY OF HIGH-RESOLUTION COMPUTED TOMOGRAPHY IN TEMPORAL BONE PATHOLOGIES

Background: Temporal bone pathologies present a wide array of diagnostic challenges due to their complex anatomical localization and nonspecific clinical presentations. Accurate imaging, particularly using High-Resolution Computed Tomography (HRCT),plays a pivotal role in evaluating these lesions and guiding surgical planning.The study aimedto assess the diagnostic accuracy of HRCT in identifying temporal bone pathologies and to correlate radiological findings with histopathological and intraoperative results.Methods:A prospective,observational cross-sectional study was conducted at the Department of Radiodiagnosis, Sri Aurobindo Medical College & PG Institute, Indore, over 18 months.A total of 40 patients with suspected temporal bone lesions underwent HRCT followed by surgical exploration or biopsy for histopathological confirmation. Data were analyzed to evaluate HRCT's sensitivity, specificity, predictive values,diagnostic accuracy,and agreement (kappa coefficient) across various pathologies.Results:The most frequent diagnosis was inflammatory lesions (40%), followed by cholesteatoma (25%), traumatic injuries (15%), benign neoplasms (7.5%), congenital malformations (7.5%), and malignant neoplasms (5%). HRCT demonstrated excellent diagnostic accuracy: sensitivity ranged from 60% to 100%, specificity from 92% to 100%, and overall accuracy above 92.5% in all categories. Kappa values showed strong agreement, particularly for cholesteatoma ( = 0.931) and inflammatory lesions ( = 0.842).Conclusion: HRCT is a reliable and highly accurate modality for diagnosing temporal bone pathologies,particularly in detecting inflammatory lesions and cholesteatoma.While histopathology remains the gold standard,HRCT significantly enhances preoperative assessment.Future studies should involve larger,multicentric cohorts with MRI correlation and long-term follow-up for improved diagnostic protocols.