Temporal Bone Cholesteatoma: Evaluation and Correlation between High Resolution Computed Tomography and Surgical Findings

Introduction: Cholesteatoma is abnormal growth of keratinizing squamous epithelium in middle ear cleft, with expansile and erosive properties and can lead to various extracranial and intracranial complications, if not operated in time. The diagnosis of cholesteatoma is usually made by otoscopic examination, but high resolution computed tomography (HRCT) is gold-standard investigation to detect the exact location and extent of disease and ant possible complications. The aim of this study was to determine the role and accuracy of HRCT temporal bone in detecting cholesteatoma of middle ear cleft and its efficacy by correlating the intra-operative findings with HRCT findings. Material and methods: This is a prospective study that included 120 cases of active squamous chronic otitis media. Each patient underwent full clinical evaluation with HRCT temporal bone. Preoperative radiological findings were correlated with surgi cal findings. Results: HRCT was found invaluable tool in identification of squamous chronic otitis media with early bony changes, had good sensitivity and specificity and helped in planning the appropriate management, but its sensitivity was found to be low for detecting erosion of facial canal, lateral semicircular canal and stapes suprastructure. Conclusion: An excellent correlation was established between preoperative HRCT and the intraoperative findings in detecting the location and extent of cholesteatoma and bony erosion of the important structures.