Radiological Evaluation of Middle Cranial Fossa Dura in Patients with Unilateral Cholesteatoma

Cholesteatoma is a common disease of the middle ear cleft associated with several complications, Surgery is the mainstay for the management of such a pathological condition, however, complications may occur including intracranial ones due to violation of middle cranial fossa dura. Anatomical variations have been reported and High-resolution CT scan is the major tool for detecting such variations. In this study, we aim to determine if there is a difference between tegmen height between both sides of patients with unilateral cholesteatoma. 21 patients were recruited for such study all underwent HRCT and the tegmen height was determined in two coronal planes, the first between the central point of the Henle spine and the tegmen, the other between the plane of both lateral canals and the roof of the middle ear. The tegmen height measurements showed that the affected side had significantly lower tegmen height Henle spine (6.30 ± 1.54 vs. 9.03 ± 1.34 (mm); p < 0.001) relative to the healthy side. Also, coronal plane measurement has shown statistical significance for tegmen height (2.98 ± 0.79 vs. 4.15 ± 0.76 (mm); p = 0.01) in comparison to the healthy side. The percentage of difference between both sides as regards tegmen height of Henle's spine and coronal measurement was 30.32% and 28.2%, respectively. A significant difference was found in tegmen height between healthy and diseased sides in patients with unilateral cholesteatoma.