title: [The use of MRI DWI-imaging in assessment of cholesteatoma recurrences after canal wall up technique].
abstract: BACKGROUND
  The use of closed technique in cholesteatoma treatment carries a significant risk of development of residual disease thus requires a second look operation in a proportion of patients. In those with no residual cholesteatoma the second surgery could be avoided.
  
  
  OBJECTIVE
  was to evaluate the use of non-echo planar HASTE diffusion-weighted MR imaging in the detection of cholesteatoma in patients after canal wall up surgery due to cholesteatoma.
  
  
  METHODS
  We evaluate the results of half-Fourier-acquisition single-shot turbo-spin-echo (HASTE) diffusion-weighted magnetic resonance imaging in 18 patients after canal wall up surgery performed 6 to 20 months after primary surgery. 16 patients were operated in our center and 2 elsewhere. All the patients underwent second look surgery that verified the result of MRI scanning.
  
  
  RESULTS
  MRI DWI detected 2 cholesteatomas in patients operated elsewhere and none in patients operated in our center. Four cholesteatomas were found during second look operations. Two false negatives were in 1 patient with cholesteatoma pearl of less than 2mm in diameter and in 1 patient with mural cholesteatoma. There were no false positive results.
  
  
  CONCLUSIONS
  Non EPI MRI DWI can be used as a screening tool to detect residual or recurrent cholesteatoma and may substitute the need of second look surgery.
authors.affiliation: Klinika Otolaryngologii i Onkologii Laryngologicznej UM w Lublinie, Poland. marcinszym@poczta.onet.pl
authors.forename: Marcin
authors.initials: M
authors.lastname: Szymański
authors.forename: Agnieszka
authors.initials: A
authors.lastname: Trojanowska
authors.forename: Anna
authors.initials: A
authors.lastname: Szymańska
authors.forename: Kamal
authors.initials: K
authors.lastname: Morshed
mesh_terms: D000293:Adolescent; D000328:Adult; D018424:Cholesteatoma, Middle Ear / Q000473:pathology* / Q000601:surgery*; D038524:Diffusion Magnetic Resonance Imaging / Q000379:methods*; D006801:Humans; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000473:pathology*; D011044:Poland; D015203:Reproducibility of Results; D024162:Second-Look Surgery / Q000379:methods*; D012680:Sensitivity and Specificity; D016896:Treatment Outcome; D055815:Young Adult