Can MRI replace a second look operation in cholesteatoma surgery?

Acta Otolaryngol. 1999;119(5):555-61. doi: 10.1080/00016489950180784.


The purpose of this paper is to investigate whether a magnetic resonance imaging (MRI) examination of the petrous bones could replace the conventional second look surgical procedure when a canal wall up tympanoplasty procedure has been performed during the first look surgery. Eighteen patients were examined with MRI prior to a second look surgical procedure. MRI was performed on a 1.5 T superconducting system. T2 weighted images before contrast and T1 weighted images after contrast (gadopentate dimeglumine) were obtained. Imaging results were compared with surgical findings. The poor radiosurgical correlation (50% and 61% after re-evaluation) suggests that, at the present time, MRI is not a valid alternative to a second look surgical intervention in the case of cholesteatoma treated by canal wall up tympanoplasty. In our study, MRI was not capable of differentiating small pearls of residual cholesteatoma from surrounding scar tissue.

Publication types

  • Case Reports
  • Comparative Study

MeSH terms

  • Adolescent
  • Adult
  • Child
  • Cholesteatoma, Middle Ear / diagnosis
  • Cholesteatoma, Middle Ear / pathology
  • Cholesteatoma, Middle Ear / surgery*
  • Cicatrix / diagnosis
  • Contrast Media
  • False Negative Reactions
  • False Positive Reactions
  • Female
  • Gadolinium DTPA
  • Granulation Tissue / pathology
  • Humans
  • Image Enhancement
  • Image Processing, Computer-Assisted / methods
  • Magnetic Resonance Imaging* / instrumentation
  • Magnetic Resonance Imaging* / methods
  • Male
  • Middle Aged
  • Petrous Bone / pathology
  • Petrous Bone / surgery
  • Recurrence
  • Reoperation
  • Reproducibility of Results
  • Single-Blind Method
  • Tympanoplasty / methods


  • Contrast Media
  • Gadolinium DTPA