Cholesteatoma of the Middle Ear and Mastoid

Mafee, Mahmood F.; Levin, Barry C.; Applebaum, Edward L.; Campos, Mario; James, Charles F.

doi:10.1016/s0030-6665(20)31539-5

Cited by 56 publications

(7 citation statements)

References 9 publications

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“…Mafee et al 10 and David et al 11 described the criteria indicating cholesteatoma as “blunting of the scutum's normally sharp tip is often the earliest sign of attic cholesteatoma.” 10,11…”

Section: Resultsmentioning

confidence: 99%

“…This is consistent with Hasso et al and Mafee et al, who mentioned that HRCT could demonstrate cholesteatoma in hidden areas such as post tympanic recesses, which could not be detected by the otologic examination. 10,13…”

Section: Resultsmentioning

confidence: 99%

“…This coincides with Mafee et al who repoted in their series of 48 patients with cholesteatoma that 46 of them (96%) had been diagnosed correctly with preoperative HRCT. 10…”

Section: Resultsmentioning

confidence: 99%

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Evaluation of Temporal Bone Cholesteatoma and the Correlation between High Resolution Computed Tomography and Surgical Finding

Gomaa

Karim

Ghany

et al. 2013

Clin Med Insights Ear Nose Throat

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BackgroundAcquired cholesteatomas are commonly seen in patients less than 30 years. There is a typical history of recurrent middle ear infections with tympanic membrane perforation. The diagnosis of cholesteatoma is usually made on otologic examination.ObjectiveThe aim of the work was to study the role of high resolution computed tomography (HRCT) in detecting, evaluating, and diagnosing middle ear cholesteatoma.Patients and methodsThis was a prospective study that included 56 consecutive patients with chronic suppurative otitis media, unsafe type cholesteatomas. Each patient was subjected to full clinical evaluation, and HRCT examination. Intravenous contrast media was used in some patients with suspected intracranial complication. Preoperative radiological data were correlated with data related to surgical findings.ResultsThe study showed that a high incidence of cholesteatoma in the third decade of life. The scutum and lateral attic wall were the most common bony erosions in the middle ear bony wall (64.3%), and the incus was the most eroded ossicle in the middle ear (88.2%). Sclerosing of mastoid air cells were encountered in 60.7% of patients and the lateral semicircular canal was affected in 9%, while facial canal erosion was found in 21.4%. Temporal bone complications are more common than intracranial complications.HRCT findings were compared with operative features; the comparative study included the accuracy and sensitivity of HRCT in detecting cholesteatoma (92.8%), its location and extension (96.4%), ossicular chain erosion (98%), labyrinthine fistula and intracranial complications (100%).ConclusionThe important role of HRCT scannig lies on the early detection of cholesteatoma, and more conservative surgical procedures can be used to eradicate the disease.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Evaluation of Temporal Bone Cholesteatoma and the Correlation between High Resolution Computed Tomography and Surgical Finding

Gomaa

Karim

Ghany

et al. 2013

Clin Med Insights Ear Nose Throat

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“…2,5 Although cholesteatoma is said to show a lower attenuation than granulation tissue the difference is subtle and only magnetic resonance imaging can differentiate the two. 6 After clinical examination, otoscopy, and a diagnosis of cholesteatoma, CT can determine its extent by revealing the combination of a soft tissue mass and bone erosion, with 80 per cent speci city. 4,7 Clinical irrelevance in predicting problems Indeed, challenging anatomy limiting access will become obvious as drilling proceeds but foreknowledge may in uence the choice of approach.…”

Section: Radiation Dosagementioning

confidence: 99%

A systematic approach to interpretation of computed tomography scans prior to surgery of middle ear cholesteatoma

Watts

Flood²,

Clifford³

2000

J. Laryngol. Otol.

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The foundation of mastoid surgery for cholesteatoma has traditionally been a thorough knowledge of the anatomy and familiarity with landmarks, constant alertness to detect unsuspected complications and the experience to tailor the surgery to the pathology encountered. Whilst not indispensable, computed tomography (CT) scanning is a useful adjunct whose potential predictive value is only truly appreciated by skilled interpretation. We present a guide to analysis to maximize the value of pre-operative radiology.

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“…On HRCT, cholesteatoma appears as a soft-tissue "mass-like" density in the middle ear cavity and mastoid antrum with associated signs of mass effect in the form of surrounding smooth bony erosions and expansion cavities [ 4 ]. The likelihood of cholesteatoma increases when the soft tissue opacity is non-dependent [ 5 ].…”

Section: Introductionmentioning

confidence: 99%

Temporal Bone Cholesteatoma: Typical Findings and Evaluation of Diagnostic Utility on High Resolution Computed Tomography

Zaman¹,

Rangankar²,

Muralinath³

et al. 2022

Cureus

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BackgroundPre-operative assessment of middle ear cholesteatoma is a must for assessing the disease's location, extent, and complication, and high-resolution computed tomography (HRCT) is the modality of choice. Therefore, this study aims to assess the common signs of cholesteatoma on HRCT and its diagnostic ability. MethodsFifty patients with suspected cholesteatoma were considered for the study, which was carried out on an Ingenuity Core 128 slice CT scanner (Philips, Amsterdam, Netherlands). The bilateral temporal bones of 50 patients were assessed for soft tissue density and associated findings. The number of temporal bones with soft tissue density was then correlated with intra-operative and histopathological examinations (HPE). ResultsOut of 100 temporal bones, 63 were diseased, and 37 were normal temporal bones. Epitympanum/Prussak's space was the most involved site with soft tissue density seen in 60/63 (95.2%) diseased temporal bones, followed by aditus ad antrum and mesotympanum, which was seen in 51/63 (80.9%) diseased temporal bones. The majority of the soft tissue lesions were non-dependent, accounting for 43/63 (68.2%) of the diseased temporal bones. Bony erosions were seen in 54/63 (85.7%) and bony expansion in 35/63 (55.5%) of the diseased temporal bones. HRCT showed a sensitivity of 100%, specificity of 88.1%, a positive predictive value (PPV) of 92.1%, a negative predictive value (NPV) of 100%, and accuracy of 95% for detection of cholesteatoma. ConclusionHRCT of the temporal bone precisely demonstrates cholesteatoma's location, extent, and bony changes. Therefore, it has exceptional sensitivity, high specificity, and accuracy in diagnosing cholesteatoma.

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Cholesteatoma of the Middle Ear and Mastoid

Cited by 56 publications

References 9 publications

Evaluation of Temporal Bone Cholesteatoma and the Correlation between High Resolution Computed Tomography and Surgical Finding

Evaluation of Temporal Bone Cholesteatoma and the Correlation between High Resolution Computed Tomography and Surgical Finding

A systematic approach to interpretation of computed tomography scans prior to surgery of middle ear cholesteatoma

Temporal Bone Cholesteatoma: Typical Findings and Evaluation of Diagnostic Utility on High Resolution Computed Tomography

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