Attic Cholesteatoma Radiopaedia

Fluid in the adjacent mastoid air cells.

Attic cholesteatoma radiopaedia.

Diffusion weighted imaging is particularly useful when distinguishing a cholesteatoma from other middle ear masses. The tegmentum tympani is intact. Radiopaedia is free thanks to our supporters and advertisers. The ossicular chain is intact.

Normally aerated mastoid air cells. Findings are characteristic of an acquired cholesteatoma. A cholesteatoma is an abnormal sac of keratinizing squamous epithelium and accumulation of keratin within the middle ear or mastoid air cell spaces which can become infected and also erode neighbouring structures. The attic is just above the eardrum.

Hrct of the temporal bone has an excellent spatial resolution thus even small soft tissue lesions can be accurately. For comparison the annual incidence of middle ear cholesteatoma is around 9 2 per 100 000. If the cholesteatoma has been dry the cholesteatoma may present the appearance of wax over the attic. The external acoustic canal is a rare location for a cholesteatoma with an estimated incidence around 1 2 per 1 000 new otological patients.

The relevant aspects of cholesteatomas are reviewed with the emphasis on their diagnosis by using cross sectional imaging. Upon reaching the posterolateral wall of the attic further expansion of the cholesteatoma is deflected superiorly toward the aditus ad antrum and mastoid antrum. As the cholesteatoma fills the aditus ad antrum the adjacent lateral semicircular canal is at risk. Small amount of soft tissue in the left middle ear.

Soft tissue occupying the right middle ear involving prussak spaces and the attic. The mass extends superiorly into the attic and appears to have eroded through the tegmentum as well as through the fallopian canal of the facial nerve and perhaps the lateral semicircular canal. An mri should be performed especially in patients with previous surgery for cholesteatoma since recurrence or residual tumor can be detected with great accuracy. The indications and limitations of ct and mr imaging and the use of novel mr imaging techniques in the diagnosis of cholesteatomas are described.

However the sequence is prone to artefact and care must be taken how the sequence is performed and interpreted 2. Conventional non contrast mr imaging with diffusion weighted imaging is recommended in all patients with a suspicion of cholesteatoma. Erosion of the malleus and incus as well as the scutum. It is the only entity that demonstrates high signal intensity on dwi.