title: Optimal use of CT imaging in pediatric congenital cholesteatoma.
abstract: OBJECTIVE
  This study aimed to determine the radiation dose of temporal bone computed tomography (TBCT) to detect pediatric congenital cholesteatoma (CC), and suggests strategy for lowering perioperative radiation dose.
  
  
  METHODS
  Fifty-three CC patients followed up for more than 12 months after surgery. Perioperative clinical findings and the effective radiation dose (ERD) of TBCT were investigated. Patients' mean age at initial TBCT was 60 months; the mean follow-up period was 43 months.
  
  
  RESULTS
  In 33 (62.3%) of 53 patients, only one TBCT was performed postoperatively. Postoperative CT imaging was performed to evaluate before second-stage ossiculoplasty, due to suspicion of CC recurrence on examinations, or as part of follow-up. When TBCT was performed on more than two occasions after surgery as a part of follow-up, there was no difference in the distribution of stage or type of CC compared to patients subjected to TBCT on less than three occasions (p=0.093 and p=0.744, respectively). During the most-recent follow-up of these 53 cases, there was no CC recurrence. The mean ERD of a single TBCT was 1.2mSv, and the mean cumulative ERD of TBCT was 2mSv per patient.
  
  
  CONCLUSIONS
  Mean and cumulative ERD of TBCT performed in CC cases was not too high to consider radiation hazard. However, efforts to minimize the number of CT scans should be taken basically.
authors.affiliation: Department of Otorhinolaryngology, Bundang CHA Medical Center, CHA University, Seongnam, Republic of Korea.
authors.forename: So Young
authors.initials: SY
authors.lastname: Kim
authors.affiliation: Department of Otorhinolaryngology, Seoul National University Boramae Medical Center, Seoul, Republic of Korea.
authors.forename: Hyo-Sang
authors.initials: HS
authors.lastname: Kim
authors.affiliation: Department of Otorhinolaryngology, Seoul National University Boramae Medical Center, Seoul, Republic of Korea.
authors.forename: Min Hyun
authors.initials: MH
authors.lastname: Park
authors.affiliation: Department of Otorhinolaryngology, Seoul National University Hospital, Republic of Korea.
authors.forename: Jun Ho
authors.initials: JH
authors.lastname: Lee
authors.affiliation: Department of Otorhinolaryngology, Seoul National University Hospital, Republic of Korea.
authors.forename: Seung Ha
authors.initials: SH
authors.lastname: Oh
authors.affiliation: Department of Otolaryngology - Head and Neck Surgery, Sungkyunkwan University, School of Medicine, Kangbuk Samsung Hospital, Seoul, Korea.
authors.forename: Sun O
authors.initials: SO
authors.lastname: Chang
authors.affiliation: Soree Ear Clinic, Seoul, Republic of Korea.
authors.forename: Chong Sun
authors.initials: CS
authors.lastname: Kim
authors.affiliation: Department of Radiology, Asan Medical Center, Seoul, Republic of Korea.
authors.forename: Ah Young
authors.initials: AY
authors.lastname: Jung
authors.affiliation: Department of Otorhinolaryngology, Seoul National University Boramae Medical Center, Seoul, Republic of Korea. Electronic address: yhkiment@gmail.com.
authors.forename: Young Ho
authors.initials: YH
authors.lastname: Kim
mesh_terms: D002648:Child; D002675:Child, Preschool; D002781:Cholesteatoma / Q000151:congenital* / Q000000981:diagnostic imaging / Q000601:surgery; D018424:Cholesteatoma, Middle Ear / Q000000981:diagnostic imaging* / Q000601:surgery; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D011829:Radiation Dosage; D012189:Retrospective Studies; D013701:Temporal Bone / Q000000981:diagnostic imaging* / Q000601:surgery; D014057:Tomography, X-Ray Computed / Q000379:methods*
keywords: Congenital cholesteatoma; Effective radiation dose; Temporal bone computed tomography