Chronic ear disease with cholesteatoma generally requires active surgical management and the requirement for this needs precise assessment. A retrospective study was conducted to evaluate the accuracy of CT scan findings in terms of predicting cholesteatoma and its associated complications such as erosion of ossicles, tegmen, facial nerve canal and lateral semi-circular canal. The sensitivity for picking up cholesteatomas varied in the anatomic sites involved, being highest for mastoid region, then mesotympanum, although this had the highest specificity and lowest for attic region. As for complications, the sensitivity was highest for ossicular erosion (sensitivity of 88%) and lowest for facial canal involvement (sensitivity of 25%) but this could have been due to lack of data in operation notes. A comparison with similar studies in literature shows wide variation. A confounding factor could be the time lag on an average of seven months between the CT scans and surgery which limits this study. However, a predictive value of 88% as evidence of cholesteatoma is notable and the role of CT scans is further supported by their ability to pick up bony complications.

Preoperative prediction of cholesteatoma from radiology: retrospective cohort study of 106 cases.
Selwyn D, Howard J, Cuddihy P.
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Madhup K Chaurasia

United Lincolnshire Hospitals NHS Trust; University of Leicester, UK.

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