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Background and Aim: Atticoantral, alias unsafe type of CSOM affects the posterosuperior part of the middle ear cleft and is frequently coupled with complications and bony erosions. This study aimed to correlate the high-resolution computed tomography (HRCT) temporal bone and intraoperative findings in the patients with the unsafe type of CSOM. Methods: This prospective study included 50 patients (28 males: 22 females; mean age 24 ± 14 years) who presented with clinically suspected unsafe CSOM. All patients underwent HRCT of the temporal bone and subsequent surgical procedure. The intraoperative and histopathological findings were compared with HRCT findings. Descriptive statistics, sensitivity, specificity, and positive and negative predictive value for HRCT were calculated. Student's t-test and Chi-square test were performed. Results: Out of 50 patients, left, right, and bilateral ear involvement were seen in 42% (21/50), 38% (19/50), and 20% (10/50) patients, respectively. Ear discharge was the most common symptom (100%) followed by earache (66%), vertigo (16%), and tinnitus (14%), respectively. Cholesteatoma was reported in 82% (49/60) of ears on HRCT while histopathological and intraoperative evaluation confirmed the diagnosis in 40 out of 49 ears. In 18% (11/60) ears, the cholesteatoma was not diagnosed on HRCT evaluation; however, the intraoperative and histopathological assessment revealed cholesteatoma in six patients while the rest had granulation tissue. For detection of ossicular erosions, tegmen erosions, erosions of facial nerve canal, erosions of sigmoid sinus plate, and erosions of lateral/posterior semicircular canals; HRCT had high sensitivity (86.44%–100%) and specificity (93.33%–100%). Conclusion: HRCT has a superb correlation with intraoperative findings and is a valuable tool for preoperative assessment of temporal bone pathologies.

The manuscript describes an unusual vascular anomaly. Persistence of carotid-vertebrobasilar anastomosis is a rare occurrence with presence of bilateral hypoglossal arteries (HAs) rarer still. We present a case of bilateral persistent HAs with hypoplastic vertebral arteries which end into posterior inferior cerebellar arteries. The computed tomography and magnetic resonance imaging appearance, course, and other associations are discussed. A review of 6 cases of bilateral HA published in the world literature is also discussed. Keywords: Persistent hypoglossal artery, Computed tomography

Objective: To evaluate the adnexal masses with conventional gray scale and color Doppler flow imaging and to assess their diagnostic reliability to differentiate benign and malignant adnexal masses. Materials and methods: We evaluated 30 patients with adnexal mass. Morphological characterization of the mass was done using Sassone score. Color Doppler parameters noted down in each patient and Caruso vascular score was also used. The results were compared with surgical/ pathological and/or follow up scans. Results: Using sonomorphological score (Sassone) overall reliability of differentiating adnexal masses had sensitivity of 91.7% and specificity of 77.7%. Using Caruso score alone we had sensitivity of 83.3% and specificity of 88.9%. Using Sassone and Caruso score together we had sensitivity of 90.9% and specificity of 93.3%. Conclusion: In evaluation of adnexal masses combining both sonomorphological and color Doppler scores which gave higher specificity and positive predictive value (PPV) than using individual score alone.