Middle ear cholesteatoma is a common inflammatory disease that requires surgery due to potentially serious intracranial complications. Diagnosis of cholesteatoma is mainly clinical, with computed tomography (CT) used to evaluate disease extension before surgery. Certain patterns of bone erosion are specific, but CT attenuation does not allow differentiation from other inflammatory middle ear diseases. With its high tissue discrimination and contrast resolution, magnetic resonance imaging is valuable in diagnosis of cholesteatomas. The learning objectives of this educational exhibit are: To review the role of HRCT...

First of all, we are going to explain the most important temporal bone anatomy in order to better understand the patological findings (Fig 1). The anatomy of this reagion include the: external ear that contains the external auditory canal and auricle (outer ear). Middle ear and eardrum wich is call the tympanic membrane that contains three ear bones or ossicles: Malleus, incus and stapes. The inner ear contains the cochlea, a snail-shaped bone which transforms sounds into nerve impulses. The vestibule, contains the utricle and...

CT FINDINGS: Attic cholesteatoma, the most common form of acquired cholesteatoma, the pars flaccida, posteriorly and superiorly located,invaginates toward the Prussak space. Cholesteatoma has an erosive potential along the ossicles and bony walls of the middle ear cavity, mostly by means of an inflammatory response that activates osteoclastic activity. The main CT findings are the followings: (Fig 6,7,8). Soft tissue mass attenuation in Prussak space medial ossicular displacement by the growing cholesteatoma are specific findings at computed tomography (CT) Extension into the mastoid antrum 70%...

CT scan is the procedure of choice for identifying tegmen erosion and when there is suspicion of an existing encephalocele,but MRI is essential to differentiate between cholesteatoma,brain herniation and inflammatory tissue. New non-EPI DWI techniques allow highly specific diagnosis of cholesteatoma, an achievement not possible with CT or conventional MR imaging techniques.These new MRI techniques are fast, produces easy-to-interpret images, and does not involve injection of paramagnetic contrast material. Moreover,Non-EPI DWI are very helpful in recurrent and residual cholesteatoma because the specificity of DWI allows...

Fernando Más-Estellés, Manuel Mateos-Fernández, Blanca Carrascosa-Bisquert, Fernando Facal de Castro, Iciar Puchades- Román, Constantino Morera-Pérez. Contemporary Non–Echo-planar Diffusion-weighted Imaging of Middle Ear Cholesteatomas. RadioGraphics 2012; 32:1197–1213 H.R. Harnsberger “Diagnostic imaging: head and neck” 1ªed AMIRSYS 2004. De Foer B, Vercruysse JP, Pouillon M, Somers T, Casselman JW, Offeciers E. Value of high-resolution computed tomography and magnetic resonance imaging in the detection of residual cholesteatomas in primary bony obliterated mastoids. Am J Otolaryngol. 2007 Jul-Aug;28(4):230-4. De Foer B, Vercruysse JP, Bernaerts A, Meersschaert J, Kenis C,...

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