ACR Appropriateness Criteria® Inflammatory Ear Disease

Mohit Agarwal, Froedtert Memorial Lutheran Hospital Medical College of Wisconsin, Milwaukee, Wisconsin. Electronic address: magarwal@mcw.edu.
Amy F. Juliano, Panel Chair, Massachusetts Eye and Ear, Harvard Medical School, Boston, Massachusetts.
Mari Hagiwara, Panel Vice-Chair, New York University Langone Health, New York, New York.
Moises Auron, Cleveland Clinic and Outcomes Research Consortium, Cleveland, Ohio; American College of Physicians, Primary care physician.
Judah Burns, Montefiore Medical Center, Bronx, New York.
Matthew L. Bush, University of Kentucky, Lexington, Kentucky; American Academy of Otolaryngology-Head and Neck Surgery.
Prachi Dubey, Houston Methodist Hospital, Houston, Texas.
Elliott R. Friedman, Houston Methodist Hospital, Houston, Texas.
Maria K. Gule-Monroe, The University of Texas MD Anderson Cancer Center, Houston, Texas.
Benjamin W. Hatten, University of Colorado School of Medicine Anschutz Medical Campus, Aurora, Colorado; American College of Emergency Physicians.
Vikas Jain, MetroHealth Medical Center, Cleveland, Ohio.
Tanya J. Rath, Mayo Clinic Arizona, Phoenix, Arizona.
Lilja B. Solnes, Johns Hopkins Bayview Medical Center, Baltimore, Maryland; Commission on Nuclear Medicine and Molecular Imaging.
M Reza Taheri, George Washington University Hospital, Washington, District of Columbia.
David Zander, University of Colorado School of Medicine Anschutz Medical Campus, Aurora, Colorado.
Bruno Policeni, Specialty Chair, University of Iowa Hospitals and Clinics, Iowa City, Iowa.

Document Type

Journal Article

Publication Date

5-1-2025

Journal

Journal of the American College of Radiology : JACR

Volume

22

Issue

5S

DOI

10.1016/j.jacr.2025.02.026

Keywords

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

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.

Department

Radiology

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