Attic Cholesteatoma Radiology

The mass extends superiorly into the attic and appears to have eroded through the tegmentum as well as through the fallopian canal of the facial nerve and perhaps the lateral semicircular canal. Diffusion weighted imaging is particularly useful when distinguishing a cholesteatoma from other middle ear masses. The external acoustic canal is a rare location for a cholesteatoma with an estimated incidence around 1 2 per 1 000 new otological patients.

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Attic cholesteatoma radiology.

The overall incidence rate in one large study was 0 30 per year per 100 000 inhabitants 1. On the dwi images with b value 1000 s mm 2 a cholesteatoma becomes apparent as a hyperintense area. Although a cholesteatoma is histologically identical to an epidermoid or epidermal. For comparison the annual incidence of middle ear cholesteatoma is around 9 2 per 100 000.

Findings are characteristic of an acquired cholesteatoma. It is the only entity that demonstrates high signal intensity on dwi. However the sequence is prone to artefact and care must be taken how the sequence is performed and interpreted 2. The signal intensity should be higher than visible on the dwi images with b value 0 s mm 2.

Keywords temporal bone cholesteatoma middle ear external auditory canal introduction a cholesteatoma is a cystic mass filled with keratin and lined by stratified squamous epithelium. This case is a histologically proven case of cholesteatoma. On the adc map a low signal should be visible in the same area confirming the presence of diffusion restriction. Cholesteatoma is not a neoplasm and can be thought of most simply as skin in the wrong place.