Is there a role for computed tomography scanning in microtia with complete aural atresia to rule out cholesteatoma?

To determine if radiologic imaging is necessary to rule out cholesteatoma in patients with congenital aural atresia.

A retrospective chart review of patients attending the BC Children's Hospital Microtia Clinic from January 1, 1990 through April 17, 2017 was undertaken. Patients with complete atresia of the external canal were included in the study. Available radiologic imaging and clinical records were examined for the presence or absence of cholesteatoma.

Of the 125 charts reviewed, 102 met criteria for inclusion in the study and 79 had three-dimensional imaging completed. None of these 102 patients had radiologic or clinical evidence of cholesteatoma.

Computed tomography and/or magnetic resonance imaging remains an essential modality in the work-up of selected patients with microtia/atresia. It may be unnecessary in the follow-up of certain patients to rule out a congenital cholesteatoma. This imaging avoidance may reduce exposure to radiation, the potential need for general anaesthesia, and unnecessary financial cost.