The value of magnetic resonance imaging in the diagnosis of residual or recurrent acquired cholesteatoma after canal wall-up tympanoplasty

Otol Neurotol. 2008 Jan;29(1):16-8. doi: 10.1097/MAO.0b013e31815dbae8.


Objective: The value of magnetic resonance imaging (MRI) in the diagnosis of recurrent or residual cholesteatoma after canal wall-up tympanoplasty is studied in a retrospective cohort study at a tertiary referral center.

Patients: A total of 31 patients, who underwent 32 canal wall-up tympanoplasty procedures with MRI before revision surgery, were included in the study.

Interventions: MRI examination, using both the conventional and echo-planar diffusion-weighted sequences, was performed, with additional spin echo diffusion-weighted MRI sequences in 4 patients. All patients were treated with a canal wall-up tympanoplasty.

Main outcome measures: The presence of residual or recurrent cholesteatoma at revision surgery is matched with preoperative findings on MRI.

Results: MRI could correctly detect the residual disease in 54.5% of the surgically matched residual or recurrent cholesteatomas. MRI yielded a false-negative result in 45.5%. There was 1 false-positive result (10%). Sensitivity, specificity, and positive and negative predictive values of MRI were 54.4%, 90%, 92.3%, and 47.4%, respectively.

Conclusion: Preoperative MRI could correctly detect residual or recurrent cholesteatoma in somewhat over half the cases. A high number of false-negative results were obtained. At thismoment, MRI cannot yet replace revision surgery.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Child
  • Cholesteatoma, Middle Ear / diagnosis*
  • Cholesteatoma, Middle Ear / surgery*
  • Cohort Studies
  • Echo-Planar Imaging*
  • False Negative Reactions
  • Female
  • Humans
  • Male
  • Middle Aged
  • Recurrence
  • Reoperation
  • Retrospective Studies
  • Semicircular Canals / surgery
  • Tympanoplasty*