title: Middle ear cholesteatoma extending into the petrous apex: evaluation by CT and MR imaging.
abstract: CT and MR imaging findings were reviewed in four cases of acquired cholesteatoma of the middle ear that extended medially into the petrous apex and middle cranial fossa. In one case the lesion further extended anteromedially into the sphenoid sinus. CT demonstrated the lesions as nonenhancing hypodense masses with bone destruction, extending medially from the middle ear cavity to the petrous apex region. On MR imaging, the lesion was slightly hypointense relative to brain on T1-weighted images and hyperintense on T2-weighted images. MR imaging clearly delineated the extraaxial location of the lesion and associated brain displacement. The medial extension of the cholesteatomas seems to have proceeded via a detour around the bony labyrinth into the petrous apex region by following normal pathways of temporal bone pneumatization.
authors.affiliation: Department of Radiology, School of Medicine, Tohoku University, Sendai, Japan.
authors.forename: K
authors.initials: K
authors.lastname: Ishii
authors.forename: S
authors.initials: S
authors.lastname: Takahashi
authors.forename: K
authors.initials: K
authors.lastname: Matsumoto
authors.forename: T
authors.initials: T
authors.lastname: Kobayashi
authors.forename: T
authors.initials: T
authors.lastname: Ishibashi
authors.forename: K
authors.initials: K
authors.lastname: Sakamoto
authors.forename: T
authors.initials: T
authors.lastname: Soda
mesh_terms: D002781:Cholesteatoma / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology; D004427:Ear Diseases / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology; D004432:Ear, Middle; D006801:Humans; D008279:Magnetic Resonance Imaging; D009361:Neoplasm Invasiveness; D010579:Petrous Bone / Q000000981:diagnostic imaging* / Q000473:pathology; D014057:Tomography, X-Ray Computed