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Updated: Aug 11, 2025
Endoscopic Cholesteatoma Surgery
Published on: January 19, 2022
The Clinical Role of Diffusion-Weighted MRI for Detecting Residual Cholesteatoma in Canal Wall up Mastoidectomy
Amr M Ismaeel1, Amir M El-Tantawy2, Mohamed G Eissawy3
1Department of Radiology, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
Objectives:
The purpose of this study was to assess the value of the diffusion MRI with the non-echoplanar imaging (Non-EPI) technique for follow-up the post-operative patients to detect residual cholesteatomas.
Study Design:
This prospective study was performed on 40 patients. All patients were at least one year after Canal Wall Up mastoidectomy surgery for cholesteatoma and scheduled for a second-look surgery.
Patients And Methods:
This prospective study was performed on 40 patients. All patients were subjected to Canal Wall Up surgery and planned for the second-look operation. After one year as removal of choleasteatoma is uncertain in first surgery. The study done at Tertiary referral centers (Ain shams, Mansoura, and Minia university hospitals), non-echoplanar diffusion MRI (NEP-DWI) technique for follow-up the post-operative patients to detect residual cholesteatomas, then second look surgery done 2 weeks after MRI.
Results:
Forty patients underwent MRI with Non-echoplanar diffusion-weighted imaging (NEP-DWI). Twenty-six patients had positive MRI results with the remaining 14 patients had negative results. These results were compared to operative findings. All positive MRI cases showed positive intra-operative findings. Ten of negative MRI cases showed negative intra-operative findings. Four of DWI-negative cases showed small cholesteatomas.
Conclusion:
The use of NEP-DWI is a valuable tool in detecting residual cholesteatoma that could replace the second look surgery in many cases.
