Contemporary radiologic imaging in the evaluation of middle ear-attic-antral complex cholesteatomas

High-resolution computerized tomography with its ability to produce excellent contrast and exquisite anatomic detail remains the primary modality in the preoperative evaluation of middle ear cholesteatomas. The radiographic findings not only support the clinical diagnosis but also determine the surgical approach. The presence of disease in areas that are difficult to evaluate, such as the sinus tympani and the anterior portion of the facial canal, can now be documented. The major contribution of MRI appears to be in defining the relationship of middle ear disease with intracranial pathology. The role of MRI in assessing focal middle ear disease awaits improved spatial resolution.