Assessment of chronic suppurative otitis media patients with cholesteatoma on the basis of gadolinium enhanced T1-T2 weighted images of MRI

Abstract

<p class="abstract"><strong>Background:</strong> The propensity for ossicular destruction is much greater in case of unsafe CSOM due to presence of cholesteatoma and/or granulations. Partial or total destruction of ossicles is seen in approximately 80% of patients with cholesteatoma, whereas in chronic otitis media without cholesteatom, ossicular chain erosion can be seen in approximately 20% cases.The present study aims to evaluate the clinical profile of patients of unsafe chronic suppurative otitis media with cholesteatoma and assesses patients on the basis of gadolinium enhanced T<sub>1</sub>-T<sub>2</sub> weighted images of MRI.</p><p class="abstract"><strong>Methods:</strong> The study was conducted among patients who were fulfilling the criteria for unsafe CSOM i.e., retraction pocket in pars tensa, marginal perforation, perforation in pars flaccida, presence of granulation tissue, presence of polyp, blood stained discharge etc. were selected for the study. MRI was performed in all cases by using gadolinium enhanced T<sub>1</sub>-T<sub>2</sub> sequences for diagnosis of cholesteatoma. Mastoidectomy was done to confirm the findings of MRI. </p><p class="abstract"><strong>Results:</strong> In maximum number of cases perforation was found in attic region. Most common complication of disease is the ossicular chain erosion. In present study sensitivity was 84%, specificity was 100% and positive predictive value and negative predictive value were 100% and 66% respectively.</p><p class="abstract"><strong>Conclusions:</strong> It can be concluded that MRI can differentiate cholesteatoma from other inflammatory etiology. By using MRI with 1.5 or 3T unit a small cholesteatoma (even 2-3 mm) can be easily detected at its early stage and further complications can be prevented.</p>