Role of Multi Detector Computed Tomography in Preoperative Evaluation of Middle Ear Cholesteatoma

Abstract
Background: Middle ear cholesteatoma is an ectopic squamous stratified epithelium in the middle ear. It is a actually risky disease as it leads to destruction of ossicles and/or walls of middle ear that causes severe complications as hearing loss and brain abscess. Pre-operative assessment of cholesteatoma by Multi-Detectors Computed Tomography (MDCT) is essen-tial for accurate diagnosis and appropriate management to prevent recurrence after surgery.
Aim of Study: To assess the diagnostic accuracy of pre-operative MDCT of middle ear cholesteatoma with surgical correlation.
Patients and Methods: A prospective study was conducted in Tanta University Hospitals from July 2015 to December 2016 on 30 patients with middle ear cholesteatoma. All patients had a pre-operative MDCT scans. The pre-operative MDCT findings were recorded and correlated with surgical and histopathological results. Sensitivity and specificity of pre-operative MDCT findings were calculated considering oper-ative findings as gold standard.
Results: The study included 30 patients, 17 were females and 13 were males with a mean age of 35 years. The diagnostic accuracy of the pre-operative MDCT findings when correlated to intraoperative ones was 100% in detecting soft tissue mass inside the middle ear, 100% in detecting the location of cholesteatoma, 100% in detecting ossicular erosion, 93.3% in detecting scutum erosion and 100% in confirming the diagnosis of cholesteatoma proved by post-operative his-topathological examination. The mean sensitivity of MDCT in preoperative diagnosis and evaluation of middle ear chole-steatoma was 97.4% while the mean specificity was 95.8%.
Conclusion: Middle ear cholesteatoma is a distinctive clinical entity with characteristic findings on MDCT scan, that guides in the surgical approach and management plan.