ACR Appropriateness Criteria® Inflammatory Ear Disease

Abstract

This document provides evidence-based guidelines for appropriateness of imaging modalities in cases of inflammatory ear disease covering acute and chronic, and uncomplicated and complicated otitis media and otitis externa in adults. Imaging recommendations for initial imaging and postoperative surveillance of cholesteatoma in adults have also been addressed. This document provides guidance for physicians in the choice of imaging while managing cases of complicated or uncomplicated inflammatory conditions of the ear, and managing initial presentation or postoperative cases of cholesteatoma. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision process support the systematic analysis of the medical literature from peer reviewed journals. Established methodology principles such as Grading of Recommendations Assessment, Development, and Evaluation or GRADE are adapted to evaluate the evidence. The RAND/UCLA Appropriateness Method User Manual provides the methodology to determine the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances where peer reviewed literature is lacking or equivocal, experts may be the primary evidentiary source available to formulate a recommendation.

Keywords: AUC; Appropriateness Criteria; CT; MRI; appropriate use criteria; cholesteatoma; complicated; otitis externa; otitis media.