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DOI: 10.1055/s-0034-1384130
Petrous Bone Cholesteatoma: The Value of MR Non-EPI-DW Imaging for Follow-Up after Surgery
Objective: New MRI sequences like the non-EPI diffusion weighted imaging technique allow for primary diagnosis and evaluation of extension of petrous bone cholesteatomas. It offers, together with HRCT/CBCT, a surgical road map and allows a more accurate counseling with respect to hearing loss and facial paresis. The sequence also has a high value in the postoperative follow-up, namely, a nonsurgical control of eradication of petrous bone cholesteatoma even in obliterated cases. In this study, the value of this technique is evaluated in petrous bone cholesteatoma patients. Study Design: retrospective study design. Material and Methods: Total 20 cases of petrous bone cholesteatoma were screened for residual/recurrent pathology. A control MRI is routinely performed at 1, 3, 5 years after surgery. Results: According to the Sanna classification: 13 (65%) were supralabyrinthine, 2 (10%) infralabyrintine, 1 (5%) infralabyrinthine-apical, 3 (15%) apical, and 1 (5%) massive. The approaches included: subtotal petrosectomy (9), transmastoid/middle fossa (4), translabyrinthine (3), translabyrinthine retrofacial (2), transotic (1), and retrolabyrinthine (1). At last follow-up MRI screening showed no evidence of disease in 14 cases (70%), 3 had residual pathology, 1 had a recurrent cholesteatoma, and 2 were lost for follow-up. Conclusion: The authors stress the importance of the use of MR non-EPI DW Imaging for the screening of residual/recurrent pathology in petrous bone cholesteatoma cases.