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Imaging Studies III: Computed Tomography01:27

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DefinitionComputed Tomography (CT) of the genitourinary (GU) tract is a non-invasive imaging modality that utilizes X-rays and computer processing to generate detailed cross-sectional images of the urinary system, encompassing the kidneys, ureters, bladder, and adjacent structures such as the adrenal glands.PurposeCT scans of the GU tract serve several diagnostic and therapeutic purposes, including:Diagnosis of Urinary Tract Diseases: Detects kidney stones, tumors, cysts, and congenital...
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Related Experiment Video

Updated: May 6, 2026

Computed Tomography and Optical Imaging of Osteogenesis-angiogenesis Coupling to Assess Integration of Cranial Bone Autografts and Allografts
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Imaging findings in auto-atticotomy.

M Manasawala1, M E Cunnane, H D Curtin

  • 1Department of Radiology, Abington Memorial Hospital, Abington, Pennsylvania.

AJNR. American Journal of Neuroradiology
|November 16, 2013
PubMed
Summary

Spontaneous cholesteatoma drainage, termed auto-atticotomy, creates a distinct air-filled cavity. CT scans reveal characteristic scutum erosion and attic widening, mimicking surgical procedures.

Area of Science:

  • Otolaryngology
  • Radiology
  • Medical Imaging

Background:

  • Acquired attic cholesteatoma can spontaneously drain externally.
  • This phenomenon, "nature's atticotomy" or auto-atticotomy, leaves an air-filled cavity.
  • The CT appearance of this cavity relative to the scutum and lateral attic wall is described.

Purpose of the Study:

  • To describe and quantify the CT appearance of auto-atticotomy cavities.
  • To correlate CT findings with scutum and lateral attic wall morphology.
  • To differentiate spontaneous drainage from surgical atticotomy on CT.

Main Methods:

  • Retrospective review of 21 patients with scutum erosion and attic wall loss on MDCT.
  • Measurement of lateral attic dimensions in axial and coronal planes.

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  • Comparison with 20 control subjects without cholesteatoma.

    • Main Results:

    • Patients exhibited scutum blunting, lower lateral attic wall loss, and attic widening.
    • Statistically significant widening (P < .001) of lateral attic dimensions was observed.
    • Findings were consistent with auto-atticotomy.

    Conclusions:

    • Spontaneously evacuated cholesteatoma can mimic surgical atticotomy on MDCT.
    • Scutal erosion and attic enlargement with smooth bony remodeling suggest prior spontaneous cholesteatoma drainage.
    • A history of surgery is crucial for differentiating from surgical intervention.