RESUMO
OBJECTIVE: To determine the diagnostic accuracy of Necrotizing Otitis Externa (NOE) based on radiologic studies. METHODS: The PubMed, Cochrane, Embase, Web of Science, SCOPUS, and Google Scholar databases were searched. True-positive and false-negative results were extracted for each study. Methodological quality was evaluated using the Quality Assessment of Diagnostic Accuracy Studies 2 (QUADAS-2) tool. RESULTS: The included studies contained data on 37 studies diagnosed with NOE. The sensitivity of gallium-67, technetium-99m, and Magnetic Resonance Imaging (MRI) was 0.9378 (0.7688-0.9856), 0.9699 (0.8839-0.9927), and 0.9417 (0.6968-0.9913), respectively. For Computed Tomography (CT), the positive criteria consisted of bony erosion alone and bony erosion plus any soft tissue abnormality. The sensitivity of CT based only on bony erosion was 0.7062 (0.5954-0.7971); it was higher 0.9572 (0.9000-0.9823) when based on bony erosion plus any soft tissue abnormality. CONCLUSION: The diagnostic sensitivity of technetium-99m, gallium-67, and MRI was favorable. On CT, the presence of bony erosion may be a useful diagnostic marker of NOE, but the diagnostic sensitivity will be even higher if the criterion of any soft tissue abnormality is also included; however, care should be taken when interpreting the results. Our study demonstrates the potential utility of radiology studies for diagnosing NOE, but their lack of specificity must be considered, and standardized anatomic criteria are still needed. LEVEL OF EVIDENCE: 2A.
Assuntos
Otite Externa , Humanos , Otite Externa/diagnóstico por imagem , Tecnécio , Tomografia por Emissão de Pósitrons , Tomografia Computadorizada por Raios X , Imageamento por Ressonância Magnética , Sensibilidade e EspecificidadeAssuntos
Humanos , Masculino , Idoso de 80 Anos ou mais , Otite Externa/diagnóstico por imagem , Nervo da Corda do Tímpano/diagnóstico por imagem , Neoplasias dos Nervos Cranianos/diagnóstico por imagem , Neurilemoma/diagnóstico por imagem , Otite Externa/patologia , Imageamento por Ressonância Magnética , Tomografia Computadorizada por Raios X , Nervo da Corda do Tímpano/patologia , Neoplasias dos Nervos Cranianos/patologia , Achados Incidentais , Neurilemoma/patologiaAssuntos
Nervo da Corda do Tímpano/diagnóstico por imagem , Neoplasias dos Nervos Cranianos/diagnóstico por imagem , Neurilemoma/diagnóstico por imagem , Otite Externa/diagnóstico por imagem , Idoso de 80 Anos ou mais , Nervo da Corda do Tímpano/patologia , Neoplasias dos Nervos Cranianos/patologia , Humanos , Achados Incidentais , Imageamento por Ressonância Magnética , Masculino , Neurilemoma/patologia , Otite Externa/patologia , Tomografia Computadorizada por Raios XRESUMO
OBJECTIVE: This study was undertaken to assess the scope of sonography for the diagnosis of diseases of the external ear. METHODS: We developed a description of the sonographic anatomy of the normal ear pinna, including the thickness of the normal cartilage and lobule, through systematic scanning of the external ears of 11 healthy volunteers (2 male and 9 female), and reviewed clinical cases with pathologic entities. RESULTS: Reproducible and recognizable images were collected from normal as well as pathologic cases of the external ear. Images are presented for reference. CONCLUSIONS: Sonography permits good visualization of the internal structure, including the cartilage, and it is possible to use sonography as a method of study to differentiate between inflammation, vascular lesions, and tumors.