title: Comparison of computed tomography and magnetic resonance imaging for evaluation of cholesteatoma with labyrinthine fistulae.
abstract: OBJECTIVE
  To compare preoperative computed tomography (CT) and magnetic resonance imaging (MRI) findings to the clinical features in patients with middle ear cholesteatoma with labyrinthine fistulae.
  
  
  METHODS
  Retrospective case series.
  
  
  METHODS
  Twenty-eight patients who underwent surgery for middle ear cholesteatoma with one or more labyrinthine fistulae confirmed by CT were studied. Preoperative imaging analysis was performed using three-dimensional fluid-attenuated inversion recovery (3D-FLAIR) MRI. Fistula size measured by CT and the signal intensity ratio (SIR) between the affected lesion in the inner ear and the cerebellum measured by 3D-FLAIR MRI were evaluated with respect to the clinical features and surgical findings.
  
  
  RESULTS
  The SIR was not correlated with fistula size. The hearing threshold determined by preoperative bone conduction correlated with the SIR, especially in patients with acute sensorineural hearing loss, but it did not correlate with fistula size. Patients with fistula symptoms had a significantly higher SIR than those without symptoms, and similar findings were observed in patients with an active infection. Patients with a larger fistula or higher SIR tended to have a deeper fistula and a more adhesive fistula matrix at operation.
  
  
  CONCLUSIONS
  SIR was more strongly correlated than CT findings to the clinical status of patients with labyrinthine fistulae caused by cholesteatoma. Adhesion of the cholesteatoma matrix to the membranous labyrinth correlated with the SIR; thus, SIR may accurately reflect the extent of inner ear dysfunction with a labyrinthine fistula.
authors.affiliation: Department of Otorhinolaryngology, Nagoya University Graduate School of Medicine, Nagoya, Japan. michsone@med.nagoya-u.ac.jp
authors.forename: Michihiko
authors.initials: M
authors.lastname: Sone
authors.forename: Tadao
authors.initials: T
authors.lastname: Yoshida
authors.forename: Shinji
authors.initials: S
authors.lastname: Naganawa
authors.forename: Hironao
authors.initials: H
authors.lastname: Otake
authors.forename: Ken
authors.initials: K
authors.lastname: Kato
authors.forename: Rui
authors.initials: R
authors.lastname: Sano
authors.forename: Masaaki
authors.initials: M
authors.lastname: Teranishi
authors.forename: Tsutomu
authors.initials: T
authors.lastname: Nakashima
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D018424:Cholesteatoma, Middle Ear / Q000150:complications / Q000175:diagnosis* / Q000601:surgery; D003937:Diagnosis, Differential; D005260:Female; D005402:Fistula / Q000150:complications / Q000175:diagnosis* / Q000601:surgery; D005500:Follow-Up Studies; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D013506:Otologic Surgical Procedures; D011379:Prognosis; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012720:Severity of Illness Index; D014057:Tomography, X-Ray Computed / Q000379:methods*; D015837:Vestibular Diseases / Q000150:complications / Q000175:diagnosis* / Q000601:surgery; D014722:Vestibule, Labyrinth; D055815:Young Adult