Cholesteatoma: diagnosis and staging by CT scan

Chronic otitis media is frequently seen in otolaryngologic practice. Cholesteatoma is less common and can present a diagnostic challenge. Temporal bone imaging studies are often used both to support the clinical diagnosis of cholesteatoma and to ascertain the extent of the disease. The exact role of CT in patients with cholesteatoma is unclear. This retrospective study compares CT with the operative findings in 44 patients operated on for cholesteatoma. Results show that while CT can detect abnormalities in the temporal bone, its ability to diagnose cholesteatoma is poor. We conclude that CT should be used selectively in those patients presenting diagnostic dilemmas or when other concomitant pathology (i.e., complications, recurrent disease, etc.) is suspected.