January 2014

Introduction

DWI of Cholesteatoma

Benjamin Huang

Benjamin Huang

Cholesteatomas of the middle ear and mastoid are a major cause of morbidity among patients with chronic otitis media and eustachian tube dysfunction, due primarily to their destructive potential. While surgical resection successfully eradicates disease in the majority of patients, recurrences after tympanomastoidectomy are still quite common, occurring in anywhere from 10–40% of cases.1,2 For this reason, many surgeons commonly perform second-look … more »

Head & Neck

Comparison of Echo-Planar Diffusion-Weighted Imaging and Delayed Postcontrast T1-Weighted MR Imaging for the Detection of Residual Cholesteatoma

Frederic Venail

Frederic Venail

Second-look, or “staged,” surgery is a common procedure performed after surgical treatment of middle ear cholesteatoma. It aims at restoring the columellar effect of the ossicular chain and searching for residual lesions of cholesteatoma. In cases of no residual cholesteatoma and fair postoperative auditory function (around 30% of cases), this second-look surgery is useless but remains necessary due to the lack … more »

Head & Neck

Single-Shot, Turbo Spin-Echo, Diffusion-Weighted Imaging versus Spin-Echo-Planar, Diffusion-Weighted Imaging in the Detection of Acquired Middle Ear Cholesteatoma

Bert De Foer

Bert De Foer

This particular paper was part of a larger project on the value of diffusion-weighted imaging in the diagnosis of middle ear cholesteatoma.

It started in the period 2000–2001, when we investigated the use of echo-planar diffusion-weighted MRI in the evaluation of patients with middle ear cholesteatoma prior to first-stage and second-stage surgery.  The conclusions were that echo-planar diffusion-weighted MRI was … more »

Head & Neck

The Diagnostic Accuracy of Non-Echo-Planar Diffusion-Weighted Imaging in the Detection of Residual and/or Recurrent Cholesteatoma of the Temporal Bone

Marjolein H.G. Dremmen

Marjolein H.G. Dremmen

In 2005 we started using non-EPI DWI sequences in cholesteatoma imaging. At a certain point in time, we noticed that the ENT surgeons in our hospital were almost completely relying on the imaging findings when screening for residual and/or recurrent cholesteatoma in patients having previously undergone surgery for cholesteatoma. The non-EPI DWI sequence, in combination with conventional MRI … more »

Review Article

The Utility of Diffusion-Weighted Imaging for Cholesteatoma Evaluation

John I. Lane

John I. Lane

We first became interested in utilizing non-EPI DWI for the detection of recurrent cholesteatomas after reading the published works of our European colleagues.1,2 Clinical diagnosis of recurrence is quite limited in patients following canal wall-up mastoidectomy and tympanoplasty procedures (often performed with opaque cartilaginous grafts), precluding adequate otoscopic inspection of the middle ear. CT is often nondiagnostic unless evidence … more »

Head & Neck

Diffusion-Weighted Imaging for Differentiating Recurrent Cholesteatoma from Granulation Tissue after Mastoidectomy: Case Report

Suresh Mukherji

Suresh Mukherji

Diffusion-weighted imaging  for distinguishing cholesteatoma from postoperative granulation is one of the most underutilized techniques for evaluating the temporal bone. Accurate detection of recurrent or residual cholesteatoma is difficult because the postoperative bony changes alter the classic CT findings necessary to confirm the diagnosis. Thus, many of the reports “waffle” in their attempt to discern the two entities.

Our paper and others … more »

Head & Neck

3T MR Imaging of Postoperative Recurrent Middle Ear Cholesteatomas: Value of Periodically Rotated Overlapping Parallel Lines with Enhanced Reconstruction Diffusion-Weighted MR Imaging

Pierre Lehmann

Pierre Lehmann

The importance of diffusion-weighted MR imaging in the detection of recurrent cholesteatoma was already known and quite well documented at the time of this study.

At the beginning, our 3T MRI was mostly used to explore brain. 3T allowed lowering section thickness without signal deterioration or consuming additional time. PROPELLER was used mainly to reduce movement artifacts. We noted fewer artifacts around the … more »