Background: To evaluate the long-term surgical outcome(s) in patients who have undergone canal-wall-down operation with mastoid and epitympanic obliteration using autologous cortical bone chips, bone pate and meatally-based musculoperiosteal flap technique.
ME-cleft is shown (important for the functional prognosis) and important preoperative landmarks warn the surgeon for eventual pitfalls. The advent of the non-EP diffusion weighted sequence in MR-imaging makes this sequence a very useful adjunctive tool in the pre-op work-up of cholesteatoma cases specially in cases suspected of intralabyrinthine spread, or extension medial to the otic capsule or intracranial invasion. Its today almost undisputed value has been demonstrated in the postoperative follow-up of cholesteatoma by the high sensitivity and specificity (in most studies well above 90%). By this innovation many "unnecessary" (because absence of residual pathology) second stage operations can today be avoided. Advantages and limitations of the two imaging techniques will be discussed. An algorithm usefull in clinical practice will be proposed
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