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  Introduction:Chronic otitis media (squamosal disease) remains a significant health problem in terms of prevalence and sequelae. The recurrent episodes of otorrhoea and mucosal changes are characterized by bone erosions, and osteitis of temporal bone and ear ossicles. This is followed by ossicular destructions and/or ankylosing which together with the tympanic membrane perforation contributes to the hearing loss. Now-a-days, HRCT of the temporal bone is gaining popularity as a diagnostic modality in COM. Computed tomography scan has allowed good preoperative imaging of anatomy and extent of the disease.Aims and objectives:- To correlate pre-operative HRCT temporal bone findings with operative findings of patients undergoing tympano-mastoid surgery in chronic otitis media cases and also to assess the extent of disease. Materials and methods:- All patients of COM (squamosal disease) attending the Department of Otorhinolaryngology, Rohilkhand Medical College and Hospital, Bareilly from 1st November 2018 to 31st October 2019. Preoperative HRCT were carried out and compared with intraoperatives findings.Results:Evaluation of 50 patients and their HRCT can provide excellent details of temporal bone anatomy, extension of cholesteatoma, status of the ossicles, facial nerve, tegmen and sinus plate. Conclusion: HRCT represents the predominant modality for defining the bony anatomy of temporal bone as well as pathologics alterations in that anatomy caused by cholesteatoma. The CT scan can accurately predict the extent of disease and is helpful for detection of dural plate erosion and ossicular erosions.

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