The value of non echo planar, diffusion-weighted magnetic resonance imaging for the detection of residual or recurrent middle-ear cholesteatoma

S. Velthuis, K. J. Van Everdingen, J. J. Quak, D. R. Colnot*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

Objective: To determine the value of non echo planar, diffusion-weighted magnetic resonance imaging for detection of residual and recurrent middle-ear cholesteatoma after combined-approach tympanoplasty. Method: The magnetic resonance imaging findings after primary surgery for cholesteatoma were compared with intra-operative findings at 'second-look' surgery or with clinical follow-up findings. Results: Forty-eight magnetic resonance imaging studies were performed in 38 patients. Second-look surgery was performed 21 times in 18 patients. The remaining patients were followed up at the out-patient clinic. There were no false-positive findings with non echo planar, diffusion-weighted magnetic resonance imaging; however, there were four false-negative findings. The mean maximum diameter of recurrent cholesteatoma, as assessed using magnetic resonance imaging, was 11.7 mm (range, 4.4-25.3 mm). The sensitivity of non echo planar, diffusion-weighted magnetic resonance imaging for detecting cholesteatoma prior to second-look surgery was 0.76, with a specificity of 1.00. When clinical follow up of the non-operated ears was included in the analysis, sensitivity was 0.81 and specificity was 1.00. Conclusion: Recurrent cholesteatoma can be accurately detected using non echo planar, diffusion-weighted magnetic resonance imaging. Our study, however, also showed some false-negative results. Therefore, strict out-patient follow up is mandatory for those considering using this technique instead of standard second-look surgery.

Original languageEnglish
Pages (from-to)599-603
Number of pages5
JournalJournal of Laryngology and Otology
Volume128
Issue number7
DOIs
Publication statusPublished - 1 Jan 2014
Externally publishedYes

Cite this