Middle ear cholesteatoma: characteristic CT findings in 64 patients

Gaurano, Joselito L; Joharjy, Ismail A.

doi:10.5144/0256-4947.2004.442

Cited by 75 publications

(93 citation statements)

References 18 publications

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“…Ossicular erosion was seen in 87% cases with cholesteatoma which is less than that seen by Gaurano and Joharjy (2004), [33] who found it in 92% cases. HRCT correctly detected ossicular erosion in 85.7% cases which is similar to studies by Mafee et al (1988), [27] Garber and Dort (1994), [30] Jackler et al (1984), [29] and Swartz (1983), [37] but contrasts with study by O'Reilly (1991), [28] where poor correlation was seen.…”

Section: Discussioncontrasting

confidence: 74%

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Radiological study of the temporal bone in chronic otitis media: Prospective study of 50 cases

Rai

2014

Indian J Otol

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Section: Discussioncontrasting

confidence: 74%

“…Scutum erosion was seen in 65% cases with cholesteatoma which is less than that seen by Gaurano and Joharjy (2004), [33] who found it in 86%. However, HRCT detected scutum erosion accurately in all cases.…”

Section: Discussioncontrasting

confidence: 73%

Radiological study of the temporal bone in chronic otitis media: Prospective study of 50 cases

Rai

2014

Indian J Otol

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“…Fifty to 97% of patients have CT evidence of the intraoperatively proved bony changes, [33][34][35] depending on the location of the erosion. Moreover, the occurrence of erosions is variable in the different types of cholesteatomas (congenital cholesteatomas-rarely; pars flaccida cholesteatomas-in 70% of cases; pars tensa cholesteatomas-in 90% of cases).…”

Section: Ctmentioning

confidence: 99%

Neuroradiology of Cholesteatomas

Baráth¹,

Huber²,

Stämpfli³

et al. 2010

AJNR Am J Neuroradiol

181

141

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SUMMARY:The relevant aspects of cholesteatomas are reviewed with the emphasis on their diagnosis by using cross-sectional imaging. The indications and limitations of CT and MR imaging and the use of novel MR imaging techniques in the diagnosis of cholesteatomas are described. HRCT of the temporal bone has an excellent spatial resolution, thus even small soft-tissue lesions can be accurately delineated (high sensitivity). However, CT has poor specificity (ie, soft-tissue structures cannot be differentiated). MR imaging with the conventional sequences (T1WI, T2WI, postcontrast T1WI) provides additional information for distinguishing different pathologic entities and for accurately diagnosing primary (nonsurgical) and residual/recurrent (surgical) cholesteatomas. Higher diagnostic specificity is achieved by introducing DW-EPI, delayed postcontrast imaging, DW-non-EPI, and DWI-PROPELLER techniques. Studies using DW-non-EPI and DWI-PROPELLER sequences show promising results related to improved diagnostic sensitivity and specificity for even small (Ͻ5 mm) cholesteatomas, thus allowing avoidance of second-look surgery in the future.ABBREVIATIONS: DWI ϭ diffusion-weighted imaging; DW-EPI ϭ diffusion-weighted echo-planar imaging; DWI-PROPELLER ϭ diffusion-weighted imaging with periodically rotated overlapping parallel lines with enhanced reconstruction; DW-non-EPI ϭ diffusion-weighted non-echo-planar imaging; EAC ϭ external auditory canal; EACC ϭ external auditory canal cholesteatoma; EPI ϭ echo-planar imaging; FIESTA ϭ fast imaging employing steady-state acquisition; FLASH ϭ fast low-angle shot; HRCT ϭ high-resolution CT; NPV ϭ negative predictive value; PPV ϭ positive predictive value; T1WI ϭ T1-weighted imaging; T2WI ϭ T2-weighted imaging; TM ϭ tympanic membrane C holesteatoma has been known for more than 300 years in the medical literature; still its precise detection with the use of cross-sectional imaging techniques remains challenging. As before, the diagnosis of a cholesteatoma at first presentation is mainly based on clinical suspicion. HRCT provides information about bony changes and intracranial complications; however, it is inaccurate for characterizing the soft-tissue mass in the temporal bone. In the past 7 years, improvements in MR imaging techniques have enhanced the sensitivity and specificity of radiologic diagnosis, which may lead to future avoidance of second-look surgeries in cases of residual/recurrent cholesteatomas.The purpose of this review article is to summarize all aspects of cholesteatomas, including their definition, history, etymology, epidemiology, classification, histology, pathophysiology, clinical signs, and neuroradiologic diagnosis. We review the latest studies on the application of new MR imaging techniques for the accurate diagnosis of cholesteatomas. Definition"Cholesteatoma" is a well-demarcated non-neoplastic lesion in the temporal bone, which is commonly described as "skin in the wrong place." History and EtymologyJoseph-Guichard Duverney, a French anatomist, was the first to d...

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“…Preoperative high-resolution CT scanning of the temporal bone has long been accepted as a clinically established procedure. Here, the suspected diagnosis of a cholesteatoma and the determination of its extent are based on the form and boundaries of soft-tissue dense clouding in the temporal bone region, and on the verification of erosion to the adjacent osseous structures [5][6][7] .…”

Section: Introductionmentioning

confidence: 99%

Diffusion-Weighted MRI in the Diagnosis of Cholesteatomas

Teschner¹,

Hinz

Stöver³

et al. 2009

ORL

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Objective: The diagnosis of a cholesteatoma can be difficult in cases with an intact tympanic membrane. The aim of our study was to examine whether diffusion-weighted MRI can confirm the diagnosis of a cholesteatoma. Study Design: A preoperative diffusion-weighted MRI (echo-planar imaging) scan of the temporal bone was performed in 31 patients with clinically suspected cholesteatoma. The diagnosis was confirmed by pathohistological examination in 18 cases, while the majority of the remaining patients showed chronic otitis media without cholesteatoma. Results: In 3 out of 18 patients with histologically confirmed cholesteatoma, diffusion-weighted imaging produced a hyperintense signal. Another 4 of the 18 cases had a questionable positive result. No increased signal was observed in 11 of these 18 patients. Of 12 patients without a cholesteatoma, 2 showed a positive signal while a questionable hyperintense signal was observed in 5 patients. Conclusions: According to our present findings, diffusion-weighted MRI (echo-planar imaging) can – with a low sensitivity and specificity – be helpful in individual cases in provisionally diagnosing a cholesteatoma in association with standard MRI and high-resolution CT, even though the lack of a hyperintense signal in diffusion-weighted MRI does not exclude a cholesteatoma.

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Middle ear cholesteatoma: characteristic CT findings in 64 patients

Cited by 75 publications

References 18 publications

Radiological study of the temporal bone in chronic otitis media: Prospective study of 50 cases

Radiological study of the temporal bone in chronic otitis media: Prospective study of 50 cases

Neuroradiology of Cholesteatomas

Diffusion-Weighted MRI in the Diagnosis of Cholesteatomas

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