Can residual cholesteatoma be detected by early postoperative DWI?
Authors:
Homolová M. 1,2; Sláviková K. 3; M. Profant 1
Authors‘ workplace:
Klinika otorinolaryngológie, chirurgie hlavy a krku LF UK a UN Bratislava
1; Detská ORL klinika LF UK a NÚDCH, Bratislava
2; Rádiológia, s. r. o., Bratislava
3
Published in:
Otorinolaryngol Foniatr, 71, 2022, No. 2, pp. 91-96.
Category:
Case Reports
doi:
https://doi.org/10.48095/ccorl202291
Overview
Residual cholesteatoma results from an incomplete surgical removal of the cholesteatoma matrix. A variety of surgical procedures are used to remove cholesteatomas with varying success rates. In extensive cholesteatomas with minimal possibility of conductive system reconstruction, subtotal petrosectomy with blind sac closure is an effective surgical procedure. Diffusion-weighted magnetic resonance imaging (DWI) and ADC maps are used in the diagnosis of recurrent cholesteatoma. We present the case of a 40-year-old man, who repeatedly underwent revision surgeries for extensive cholesteatoma recidivism. An early postoperative DWI in the first days after the revision intervention did not show residual cholesteatoma. Surprisingly, a follow-up DWI detected the presence of cholesteatoma a few months later. The goal of this paper is to open the discussion on early postoperative DW MRI.
Keywords:
recidivism – residual and recurrent cholesteatoma – DWI – ADC map – subtotal petrosectomy – blind sac closure
Sources
1. Yung M, Tono T, Olszewska E et al. EAONO/JOS Joint Consensus Statements on the Definitions, Classification and Staging of Middle Ear Cholesteatoma. J Int Adv Otol 2017; 13 (1): 1–8. Doi: 10.5152/iao.2017.3363.
2. Gaillardin L, Lescanne E, Moriniere S et al. Residual cholesteatoma: prevalence and location. Follow-up strategy in adults. Eur Ann Otorhinolaryngol Head Neck Dis 2012; 129 (3): 136–140. Doi: 10.1016/j.anorl.2011.01. 009.
3. van Dinther JJ, Vercruysse JP, Camp S et al. The Bony Obliteration Tympanoplasty in Pediatric Cholesteatoma: Long-term Safety and Hygienic Results. Otol Neurotol 2015; 36 (9): 1504–1509. Doi: 10.1097/MAO.00000000000 00851.
4. Hellingman CA, Geerse S, de Wolf MJF et al. Canal wall up surgery with mastoid and epitympanic obliteration in acquired cholesteatoma. Laryngoscope 2019; 129 (4): 981–985. Doi: 10.1002/lary.27588.
5. Kronenberg J, Shapira Y, Migirov L. Mastoidectomy reconstruction of the posterior wall and obliteration (MAPRO): preliminary results. Acta Otolaryngol 2012; 132 (4): 400–403. Doi: 10.3109/00016489.2011.643456.
6. Tomlin J, Chang D, McCutcheon B et al. Surgical technique and recurrence in cholesteatoma: a meta-analysis. Audiol Neurootol 2013; 18 (3): 135–142. Doi: 10.1159/000346140.
7. van der Toom HFE, van der Schroeff MP, Pauw RJ. Single-Stage Mastoid Obliteration in Cholesteatoma Surgery and Recurrent and Residual Disease Rates: A Systematic Review. JAMA Otolaryngol Head Neck Surg 2018; 144 (5): 440–446. Doi: 10.1001/jamaoto.2017.3401.
8. Vercruysse JP, De Foer B, Somers T et al. Long-term follow up after bony mastoid and epitympanic obliteration: radiological findings. J Laryngol Otol 2010; 124 (1): 37–43. Doi: 10.1017/S002221510999106X.
9. Walker PC, Mowry SE, Hansen MR et al. Long-term results of canal wall reconstruction tympanomastoidectomy. Otol Neurotol 2014; 35 (6): 954–960. Doi: 10.1097/mao.0b013e3182a446da.
10. Kraus M, Hassannia F, M JB et al. Long-Term Outcomes from Blind Sac Closure of the External Auditory Canal: Our Institutional Experience in Different Pathologies. J Int Adv Otol 2020; 16 (1): 58–62. Doi: 10.5152/iao.2020.7688.
11. Muzaffar SJ, Dawes S, Nassimizadeh AK et al. Blind sac closure: a safe and effective management option for the chronically discharging ear. Clin Otolaryngol 2017; 42 (2): 473–477. Doi: 10.1111/coa.12634.
12. Patel M, Loan FL, Lyon JR et al. Blind sac closure of the external auditory canal for chronic middle ear disease. Otol Neurotol 2014; 35 (1): e36-39. Doi: 10.1097/MAO.0000000000000201.
13. Prasad SC, Roustan V, Piras G et al. Subtotal petrosectomy: Surgical technique, indications, outcomes, and comprehensive review of literature. Laryngoscope 2017; 127 (12): 2833–2842. Doi: 10.1002/lary.26533.
14. Bakaj T, Bakaj Zbrožková L, Salzman R et al. Role zobrazovacích metod v diagnostickém a terapeutickém postupu u cholesteatomu spánkové kosti. Otorinolaryngol Foniatr 2016; 65 (3): 173–178.
15. Haginomori S, Takamaki A, Nonaka R et al. Residual cholesteatoma: incidence and localization in canal wall down tympanoplasty with soft-wall reconstruction. Arch Otolaryngol Head Neck Surg 2008; 134 (6): 652–657. Doi: 10.1001/archotol.134.6.652.
16. Kerckhoffs KG, Kommer MB, van Strien TH et al. The disease recurrence rate after the canal wall up or canal wall down technique in adults. Laryngoscope 2016; 126 (4): 980–987. Doi: 10.1002/lary.25591.
17. Nyrop M, Bonding P. Extensive cholesteatoma: long-term results of three surgical techniques. J Laryngol Otol 1997; 111 (6): 521–526. Doi: 10.1017/s002221510013782x.
18. Stankovic M. Follow-up of cholesteatoma surgery: open versus closed tympanoplasty. ORL J Otorhinolaryngol Relat Spec 2007; 69 (5): 299–305. Doi: 10.1159/000105482.
19. O‘Leary S, Veldman JE. Revision surgery for chronic otitis media: recurrent-residual disease and hearing. J Laryngol Otol 2002; 116 (12): 996–1000. Doi: 10.1258/002221502761698711.
20. Muzaffar J, Metcalfe C, Colley S et al. Diffusion-weighted magnetic resonance imaging for residual and recurrent cholesteatoma: a systematic review and meta-analysis. Clin Otola- ryngol 2017; 42 (3): 536–543. Doi: 10.1111/coa. 12762.
21. Akkari M, Gabrillargues J, Saroul N et al. Contribution of magnetic resonance imaging to the diagnosis of middle ear cholesteatoma: analysis of a series of 97 cases. Eur Ann Otorhinolaryngol Head Neck Dis 2014; 131 (3): 153–158. Doi: 10.1016/j.anorl.2013.08.002.
22. Alvo A, Garrido C, Salas A et al. Use of non--echo-planar diffusion-weighted MR imaging for the detection of cholesteatomas in high-risk tympanic retraction pockets. AJNR Am J Neuroradiol 2014; 35 (9): 1820–1824. Doi: 10.3174/ajnr.A3952.
23. De Foer B, Vercruysse JP, Bernaerts A et al. Detection of postoperative residual cholesteatoma with non-echo-planar diffusion-weighted magnetic resonance imaging. Otol Neurotol 2008; 29 (4): 513–517. Doi: 10.1097/MAO. 0b013e31816c7c3b.
24. Plouin-Gaudon I, Bossard D, Fuchsmann C et al. Diffusion-weighted MR imaging for evaluation of pediatric recurrent cholesteatomas. Int J Pediatr Otorhinolaryngol 2010; 74 (1): 22–26. Doi: 10.1016/j.ijporl.2009.09.035.
25. Profant M, Slavikova K, Kabatova Z et al. Predictive validity of MRI in detecting and following cholesteatoma. Eur Arch Otorhinolaryngol 2012; 269 (3): 757–765. Doi: 10.1007/s00405-011-1706-8.
Labels
Audiology Paediatric ENT ENT (Otorhinolaryngology)Article was published in
Otorhinolaryngology and Phoniatrics
2022 Issue 2
Most read in this issue
- Sudden sensorineural hearing loss in children: a review of diagnosis, treatment, and prognosis
- Laryngeal fracture – a case report
- Enhanced contact endoscopy – new diagnostic method of cancerous and precancerous lesions of head and neck mucosa
- Sinonasal teratocarcinosarcoma