The value of magnetic resonance imaging in the diagnosis of residual or recurrent acquired cholesteatoma after canal wall-up tympanoplasty.
OBJECTIVE
The value of magnetic resonance imaging (MRI) in the diagnosis of recurrent or residual cholesteatoma after canal wall-up tympanoplasty is studied in a retrospective cohort study at a tertiary referral center.


METHODS
A total of 31 patients, who underwent 32 canal wall-up tympanoplasty procedures with MRI before revision surgery, were included in the study.


METHODS
MRI examination, using both the conventional and echo-planar diffusion-weighted sequences, was performed, with additional spin echo diffusion-weighted MRI sequences in 4 patients. All patients were treated with a canal wall-up tympanoplasty.


METHODS
The presence of residual or recurrent cholesteatoma at revision surgery is matched with preoperative findings on MRI.


RESULTS
MRI could correctly detect the residual disease in 54.5% of the surgically matched residual or recurrent cholesteatomas. MRI yielded a false-negative result in 45.5%. There was 1 false-positive result (10%). Sensitivity, specificity, and positive and negative predictive values of MRI were 54.4%, 90%, 92.3%, and 47.4%, respectively.


CONCLUSIONS
Preoperative MRI could correctly detect residual or recurrent cholesteatoma in somewhat over half the cases. A high number of false-negative results were obtained. At thismoment, MRI cannot yet replace revision surgery.
Jeunen
Gert
G
Department of Otolaryngology, Gasthuisberg University Hospital, Catholic University of Leuven, Leuven, Belgium. gjeunen@mznl.be
Desloovere
Christian
C
Hermans
Robert
R
Vandecaveye
Vincent
V
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D018424:Cholesteatoma, Middle Ear / Q000175:diagnosis* / Q000601:surgery*; D015331:Cohort Studies; D017352:Echo-Planar Imaging; D005188:False Negative Reactions; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012086:Reoperation; D012189:Retrospective Studies; D012665:Semicircular Canals / Q000601:surgery; D014433:Tympanoplasty