The Role of Imaging Methods in Diagnostic and Therapeutic Management of Middle Ear Cholesteatoma
Authors:
T. Bakaj 1; L. Bakaj Zbrožková 2; Richard Salzman 1
; M. Heřman 2; I. Stárek 1
Authors‘ workplace:
Otolaryngologická klinika LF UP a FN Olomouc
1; Radiologická klinika LF UP a FN Olomouc
2
Published in:
Otorinolaryngol Foniatr, 65, 2016, No. 3, pp. 173-178.
Category:
Review Article
Overview
At the present time a closed operational technique (canal wall up – CWU) or an open technique (canal wall down – CWD with canal wall reconstruction or mastoid cavity obliteration in the treatement of middle ear cholesteatoma is preferred. Due to relatively high risk of residual and/or reccurent disease, a control, second-look operation is indicated. Majority of patients are yet free of the disease, and thus exposed to unnecessary operational risks. Therefore, less invasive imaging methods for the detection of recidivous cholesteatoma are investigated.
Lately, magnetic resonance (MR) with high predictive value has overcome previously used high resolution computed tomography (HRCT).
This paper presents a brief review of imaging methods possibilities in the diagnosis of primary cholesteatoma, as well as its postoperative recidivism. The abilities of HRCT and especially importance of new MR methods, like delayed postcontrast imaging (DPI), convetional echo- planar diffusion-weighted imaging (DWI) and non-echo-planar diffusion-weighted imaging (non-EPI DWI) are discussed.
Non-EPI DWI technique has the main contribution in assesement of postoperative changes and potentional cholesteatoma recidivism, thereby is preferred nowadays.
Keywords:
cholesteatoma, middle ear, MR, non-EPI DWI
Sources
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