J Korean Radiol Soc.  1990 Dec;26(6):1104-1115. 10.3348/jkrs.1990.26.6.1104.

CT of cholesteatomas-in respect to bony complications-

• Kim HJ
• Chung HG
• Gong JC
• Shin SO
• Jeon SY
• Lim BH
• Kim JH
• Do YS
• Chung SH

• KMID: 2358763
• DOI: http://doi.org/10.3348/jkrs.1990.26.6.1104

Abstract

We retrospectively analized twenty-eitht cases of surgically confirmed cholesteatoma with CT putting emphasison the following items: (1) location and extent of cholesteatoma; (2) erosion of scutum and lateral attic wall;(3) erosion of the ossicles;(4) erosion of the bony labyrinth;(5) erosion of the facial nerve canal;(6) erosion ofthe tegmen;(7) erosion of the sigmoid sinus plate;(8) erosion of the bony external auditory canal ; and (9)intracranial complications. CT correctly predicted extent of 16 cases among surgically well documented 23cholesteatomas. It was difficult to differentiate cholesteatoma from granulation tissue. Erosion of the scutumand/or lateral attic wall was seen in 16 cases (57%). The diagnostic accuracy of CT in the evaluation of thestatus of the ossicles was 92%(22/24). The most commonly involved portion of the ossicles was the long process ofincus. There were seven cases having erosion of the bony labyrinth. Lateral semicircular canal was exclusivelyeroded. Coronal CT depicted erosion of lateral semicircular canal more accurately. Facial nerve canal erosion wasfound in six cases (21%). Eroded portion was distal limb of the first genu and mastoid segment each in threecases. Erosion of tegmen and sigmoid sinus plate was identified in four (14%) and six cases (21%), respectively.There were three cases of intracranial complication, manifest as lateral sinus thrombosis in two cases andepidural abscess in one case. All these three cases had erosion of the sigmoid sinus plate. We experienced threecases of "automastoidectomy" and two cases of "impending automastoidectomy". In both of these two conditions, thepatterns of esosion of EAC were very similar. The only difference was that whether the spontaneous drainage ofcholesteatomatous mass had occurred or not yet. At the end of this issue, we briefly comment the CT findings ofrecurrent cholesteatoma we experienced in three cases. We believe high-resolution CT is a very reliable method andshould be the first step in the evaluation of cholesteatoma.

MeSH Terms

Abscess
Cholesteatoma
Colon, Sigmoid
Cytochrome P-450 CYP1A1
Drainage
Ear Canal
Ear, Inner
Extremities
Facial Nerve
Granulation Tissue
Lateral Sinus Thrombosis
Mastoid
Methods
Retrospective Studies
Semicircular Canals
Cytochrome P-450 CYP1A1