Attic Cholesteatoma Radiopaedia

Upon reaching the posterolateral wall of the attic further expansion of the cholesteatoma is deflected superiorly toward the aditus ad antrum and mastoid antrum.

Attic cholesteatoma radiopaedia.

The ossicular chain is intact. The indications and limitations of ct and mr imaging and the use of novel mr imaging techniques in the diagnosis of cholesteatomas are described. As the cholesteatoma fills the aditus ad antrum the adjacent lateral semicircular canal is at risk. The relevant aspects of cholesteatomas are reviewed with the emphasis on their diagnosis by using cross sectional imaging.

If untreated a cholesteatoma can eat into the three small bones located in the middle ear the malleus incus and stapes collectively called ossicles which can result in nerve deterioration deafness imbalance and vertigo. The attic is just above the eardrum. However the sequence is prone to artefact and care must be taken how the sequence is performed and interpreted 2. For comparison the annual incidence of middle ear cholesteatoma is around 9 2 per 100 000.

An mri should be performed especially in patients with previous surgery for cholesteatoma since recurrence or residual tumor can be detected with great accuracy. Conventional non contrast mr imaging with diffusion weighted imaging is recommended in all patients with a suspicion of cholesteatoma. This case is a histologically proven case of cholesteatoma. A cholesteatoma is an abnormal sac of keratinizing squamous epithelium and accumulation of keratin within the middle ear or mastoid air cell spaces which can become infected and also erode neighbouring structures.

The external acoustic canal is a rare location for a cholesteatoma with an estimated incidence around 1 2 per 1 000 new otological patients. The tegmentum tympani is intact. Erosion of the malleus and incus as well as the scutum. Soft tissue occupying the right middle ear involving prussak spaces and the attic.

It is the only entity that demonstrates high signal intensity on dwi. If the cholesteatoma has been dry the cholesteatoma may present the appearance of wax over the attic. Radiopaedia is free thanks to our supporters and advertisers. Normally aerated mastoid air cells.

Hrct of the temporal bone has an excellent spatial resolution thus even small soft tissue lesions can be accurately. Small amount of soft tissue in the left middle ear. Diffusion weighted imaging is particularly useful when distinguishing a cholesteatoma from other middle ear masses. The overall incidence rate in one large study was 0 30 per year per 100 000 inhabitants 1.