Computed Tomography Staging of Middle Ear Cholesteatoma

Abstract

SummaryBackgroundTo establish computed tomography (CT) staging of middle ear cholesteatoma and assess its impact on the selection of the surgical procedure.Material/MethodsProspective study was conducted on 61 consecutive patients (mean age 26.8 years) with middle ear cholesteatoma. CT scan of the temporal bone and surgery were performed in all patients. CT staging classified cholesteatoma according to its location in the tympanic cavity (T); extension into the mastoid (M); and associated complications (C). Cholesteatoma was staged as stage I (T1, T2), stage II (T3, M1, M2, C1), and stage III (C2).ResultsThe overall sensitivity of CT staging of cholesteatoma compared to surgery was 88% with excellent agreement and correlation between CT findings and intra-operative findings (K=0.863, r=0.86, P=0.001). There was excellent agreement and correlation of CT staging with surgical findings for T location (K=0.811, r=0.89, P=0.001), good for M extension (K=0.734, r=0.88, P=0.001), and excellent for associated C complications (K=1.00, r=1.0, P=0.001). Atticotympanotomy was carried out in stage I (n=14), intact canal wall surgery was performed in stage II (n=38), and canal wall down surgery was done in stage III (n=5) and stage II (n=4).ConclusionsWe established CT staging of middle ear cholesteatoma that helps surgeons to select an appropriate surgery.

New methods for specialized subjective and high-precision objective evaluation of constricted ears

“…[ 16 ] Noninvasive magnetic resonance (MR) and computed tomography (CT) scans have been widely used for data collection in the past and have been shown to be appropriate for diagnosis, surgery selection, and outcome assessment. [ 17 , 18 ] However, MR scans are time-consuming and costly, and exposure to radiation cannot be avoided when performing CT scans. In this study, a 3D surface scanner with no radiation was used.…”

Middle Ear and Mastoid Diseases: Literature Review and New Classification Proposal

“…In the literature is already described the use of the first letter of the anatomic district involved by pathology, usually associated with a number that indicates the specific local involvement described on CT imaging [16].…”

“…In the literature is already described the use of the first letter of the anatomic district involved by pathology, usually associated with a number that indicates the specific local involvement described on CT imaging [ 16 ]. The large amount of further new classifications and reworks has been the consequence of the difficulty and the complexity to define an immediate and exhaustive description of the cholesteatoma and its extension.…”

The routes of infection spread in central skull-base osteomyelitis and the diagnostic role of CT and MRI scans

“…CT is used abundantly to determine the extent of temporal bone lesions. For example, in chronic otitis media with cholesteatoma the preoperative classification is based on CT examination [4]. Magnetic resonance imaging (MRI) is essential for determining soft tissue involvement, and in the area of the external auditory canal, not only the size of the tumour but also the type of malignancy can be judged on the basis of diffusion-weighted MRI [5].…”