Radiologic evaluation of the ear anatomy in pediatric cholesteatoma.
The aim of the study was to describe computed tomography (CT) findings in middle ear cholesteatoma in pediatric patients. A cohort of 32 children with cholesteatoma (3-14 years old) entered the study. From them, 30 presented acquired cholesteatoma (AC), and 2 presented congenital cholesteatoma. All of the children were investigated using CT before surgery of the middle ear and mastoid. Computed tomography was performed with 1- or 2-mm axial and coronal sections of both temporal bones. Nineteen children with AC (63.3%) revealed a diffuse soft-tissue density isodense with muscle, whereas in 6 of them, the mass mimicked inflammation. The remaining revealed localized soft-tissue mass with partially lobulated contour. In AC, ossicular erosion was detected in 23 cases (76.7%), abnormal pneumatization in 19 cases (63.3%), and erosion-blunting of spur and enlargement of middle ear or mastoid in 8 cases (26.7%). The 2 congenital cholesteatomas revealed soft-tissue mass with polypoid densities, while a semicircular canal fistula was detected in one of them. High-resolution CT facilitates early diagnosis and appropriate treatment of pediatric cholesteatoma by assessing the anatomic abnormalities and the extent of disease, which are crucial in middle ear and mastoid surgery.
Manolis
Evangelos N
EN
Department of Otolaryngology, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, Massachusetts, USA. ENManolis@yahoo.gr
Filippou
Dimitrios K
DK
Tsoumakas
Constantinos
C
Diomidous
Marianna
M
Cunningham
Michael J
MJ
Katostaras
Theophanis
T
Weber
Alfred L
AL
Eavey
Roland D
RD
D000293:Adolescent; D002558:Cerebrospinal Fluid Otorrhea / Q000000981:diagnostic imaging / Q000601:surgery; D002648:Child; D002675:Child, Preschool; D018424:Cholesteatoma, Middle Ear / Q000000981:diagnostic imaging* / Q000601:surgery; D015331:Cohort Studies; D004432:Ear, Middle / Q000000981:diagnostic imaging / Q000601:surgery; D042241:Early Diagnosis; D005260:Female; D005402:Fistula / Q000000981:diagnostic imaging / Q000601:surgery; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods; D007759:Labyrinth Diseases / Q000000981:diagnostic imaging / Q000601:surgery; D008297:Male; D008416:Mastoid / Q000000981:diagnostic imaging / Q000601:surgery; D011127:Polyps / Q000000981:diagnostic imaging / Q000601:surgery; D012665:Semicircular Canals / Q000000981:diagnostic imaging / Q000601:surgery; D013701:Temporal Bone / Q000000981:diagnostic imaging / Q000601:surgery; D014057:Tomography, X-Ray Computed / Q000379:methods*; D018058:Tympanic Membrane Perforation / Q000000981:diagnostic imaging / Q000601:surgery