title: Computed Tomography Staging of Middle Ear Cholesteatoma.
abstract: BACKGROUND
  To establish computed tomography (CT) staging of middle ear cholesteatoma and assess its impact on the selection of the surgical procedure.
  
  
  METHODS
  Prospective study was conducted on 61 consecutive patients (mean age 26.8 years) with middle ear cholesteatoma. CT scan of the temporal bone and surgery were performed in all patients. CT staging classified cholesteatoma according to its location in the tympanic cavity (T); extension into the mastoid (M); and associated complications (C). Cholesteatoma was staged as stage I (T1, T2), stage II (T3, M1, M2, C1), and stage III (C2).
  
  
  RESULTS
  The overall sensitivity of CT staging of cholesteatoma compared to surgery was 88% with excellent agreement and correlation between CT findings and intra-operative findings (K=0.863, r=0.86, P=0.001). There was excellent agreement and correlation of CT staging with surgical findings for T location (K=0.811, r=0.89, P=0.001), good for M extension (K=0.734, r=0.88, P=0.001), and excellent for associated C complications (K=1.00, r=1.0, P=0.001). Atticotympanotomy was carried out in stage I (n=14), intact canal wall surgery was performed in stage II (n=38), and canal wall down surgery was done in stage III (n=5) and stage II (n=4).
  
  
  CONCLUSIONS
  We established CT staging of middle ear cholesteatoma that helps surgeons to select an appropriate surgery.
authors.affiliation: Department of Diagnostic Radiology, Mansoura Faculty of Medicine, Mansoura, Egypt.
authors.forename: Ahmed Abdel Khalek Abdel
authors.initials: AA
authors.lastname: Razek
authors.affiliation: Department of Otolaryngology Head and Neck Surgery, Mansoura Faculty of Medicine, Mansoura, Egypt.
authors.forename: Mohamed Rashad
authors.initials: MR
authors.lastname: Ghonim
authors.affiliation: Department of Otolaryngology Head and Neck Surgery, Mansoura Faculty of Medicine, Mansoura, Egypt.
authors.forename: Bassem
authors.initials: B
authors.lastname: Ashraf
keywords: Adenovirus Infections, Human; Anatomy, Comparative; Imaging, Three-Dimensional; Pain