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Temporal Bone, Acquired Cholesteatoma: Multimedia
Updated: May 1, 2007
Multimedia
 | Media file 1: Coronal high-resolution computed tomography scan shows a cholesteatoma in the posterior epitympanum (blue arrow), erosion of the scutum (white arrow), and rectification of the cochlea (red arrow). |
 | Media file 2: Temporal bone, acquired cholesteatoma. Epitympanic cholesteatoma. Coronal high-resolution CT scan of the right ear shows an eroded scutum and a soft-tissue mass between the ossicular chains. |
 | Media file 3: Temporal bone, acquired cholesteatoma. Coronal high-resolution CT scan shows a right epitympanic cholesteatoma, with erosion of the tegmen, ossicular chain (1), and facial nerve (2). |
 | Media file 4: Temporal bone, acquired cholesteatoma. Coronal high-resolution CT scan shows a soft-tissue mass in the epitympanum and over the oval window, an eroded scutum (red arrow), and an atelectatic tympanic membrane. |
 | Media file 5: Temporal bone, acquired cholesteatoma. Multiple coronal CT scans show a soft-tissue mass (cholesteatoma) extending into the mastoid pneumatic system. The mastoid portion of the facial nerve (blue arrow) is seen. |
 | Media file 6: Temporal bone, acquired cholesteatoma. Keratosis obturans. Coronal high-resolution CT scan shows destruction of the external auditory canal, lateral to the tympanic membrane (blue arrows), and accumulation of epithelium in the canal (red arrow). |
 | Media file 7: Temporal bone, acquired cholesteatoma. Keratosis obturans. Coronal CT scan shows a soft-tissue mass (epithelium) obstructing the external auditory canal (blue arrow). |
 | Media file 8: Temporal bone, acquired cholesteatoma. Coronal high-resolution CT scan shows a mastoid cavity (canal-wall-down mastoidectomy) in the left ear. |
 | Media file 9: Temporal bone, acquired cholesteatoma. Coronal CT of right cholesteatoma. A large soft-tissue mass in the right middle ear extending medial to the ossicles. The scutum is eroded and tympanic membrane is retracted. Note associated erosion of tegmen tympani. The normal left ear is shown for comparison. |
 | Media file 10: Temporal bone, acquired cholesteatoma. Axial CT scan of left cholesteatoma. A soft-tissue mass in the middle ear with destruction of ossicles and erosion of the walls of middle ear cavity. |
 | Media file 11: Temporal bone, acquired cholesteatoma. Axial CT scan of right cholesteatoma shows a large cavity in the right mastoid air cells; this is consistent with an automastoidectomy. |
 | Media file 12: Temporal bone, acquired cholesteatoma. Coronal high-resolution CT scan shows an epitympanic cholesteatoma with erosion of the tegmen tympani and probable herniation of brain tissue into the middle ear. |
 | Media file 13: Temporal bone, acquired cholesteatoma. CT scan in the same patient as in Image 12. This more posterior image shows the integrity of the mastoid tegmen. |
 | Media file 14: Temporal bone, acquired cholesteatoma. Axial MRI of the same patient as in Images 12-13 was used to identify the integrity of the brain tissue and a small right temporal-bone cholesteatoma. This produces a low signal intensity on T1-weighted images and high signal intensity on T2-weighted images and, sometimes, peripheral contrast enhancement. |
 | Media file 15: Temporal bone, acquired cholesteatoma. Coronal MRI in the same patient as in Images 12-14. |
 | Media file 16: Temporal bone, acquired cholesteatoma. Coronal high-resolution CT scan in a patient who underwent 3 previous otologic surgeries in the right ear. Image shows tegmen dehiscence and a mastoid cavity filled with soft-tissue attenuation of uncertain origin, which is probably brain-tissue herniation, residual cholesteatoma, or fibrosis. |
 | Media file 17: Temporal bone, acquired cholesteatoma. Coronal T1-weighted MRI shows evident integrity of the dura without herniation of brain tissue (in the same patient as in Image 16). Gadolinium enhancement of the mastoid is seen; this corresponds with fibrosis seen at surgery. |
 | Media file 18: Temporal bone, acquired cholesteatoma. Coronal CT scan in a 70-year-old patient with right-sided, long-standing, temporal-bone cholesteatoma. Image shows extensive erosion. |
 | Media file 19: Temporal bone, acquired cholesteatoma. Contrast-enhanced coronal CT scan (in the same patient as in Image 18) was obtained to rule out intracranial complications. |
 | Media file 20: Temporal bone, acquired cholesteatoma. Contrast-enhanced coronal CT scan (in the same patient as in Image 18) shows destruction of right tegmen tympani and dural enhancement. |
 | Media file 21: Temporal bone, acquired cholesteatoma. Contrast enhanced T1-weighted axial MRI in the same patient as in Image 20 shows an enhancing soft-tissue mass in the region of the right tegmen tympani. |
 | Media file 22: Temporal bone, acquired cholesteatoma. T1-weighted axial MRI in the same patient as in Image 18. Hypointense soft-tissue mass in the region of right tegmen tympani extends intracranially. |
 | Media file 23: Temporal bone, acquired cholesteatoma. T2-weighted axial MRI in the same patient as in Image 18. MRI shows a hyperintense mass in the region of right tegmen tympani with intracranial extension. |
More on Temporal Bone, Acquired Cholesteatoma |
| Overview: Temporal Bone, Acquired Cholesteatoma |
| Imaging: Temporal Bone, Acquired Cholesteatoma |
| Follow-up: Temporal Bone, Acquired Cholesteatoma |
 Multimedia: Temporal Bone, Acquired Cholesteatoma |
| References |
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References
Derlacki EL, Clemis JD. Congenital cholesteatoma of the middle ear and mastoid. Ann Otol Rhinol Laryngol. Sep 1965;74(3):706-27. [Medline].
Levenson MJ, Parisier SC, Chute P, et al. A review of twenty congenital cholesteatomas of the middle ear in children. Otolaryngol Head Neck Surg. Jun 1986;94(5):560-7. [Medline].
Jackler RK. The surgical anatomy of cholesteatoma. Otolaryngol Clin North Am. Oct 1989;22(5):883-96. [Medline].
Liu DP, Bergeron RT. Contemporary radiologic imaging in the evaluation of middle ear-attic-antral complex cholesteatomas. Otolaryngol Clin North Am. Oct 1989;22(5):897-909. [Medline].
Dubrulle F, Souillard R, Chechin D, et al. Diffusion-weighted MR imaging sequence in the detection of postoperative recurrent cholesteatoma. Radiology. Feb 2006;238(2):604-10. [Medline]. [Full Text].
Bowes AK, Wiet RJ, Monsell EM, et al. Brain herniation and space-occupying lesions eroding the tegmen tympani. Laryngoscope. Oct 1987;97(10):1172-5. [Medline].
Daniels DL, Czervionke LF, Pojunas KW, et al. Facial nerve enhancement in MR imaging. AJNR Am J Neuroradiol. Jul-Aug 1987;8(4):605-7. [Medline].
De Foer B, Vercruysse JP, Pilet B, et al. Single-shot, turbo spin-echo, diffusion-weighted imaging versus spin-echo-planar, diffusion-weighted imaging in the detection of acquired middle ear cholesteatoma. AJNR Am J Neuroradiol. Aug 2006;27(7):1480-2. [Medline].
Edelstein DR, Parisier SC. Surgical techniques and recidivism in cholesteatoma. Otolaryngol Clin North Am. Oct 1989;22(5):1029-40. [Medline].
Farrior JB. Surgery for Cholesteatoma: Complications in Head and Neck Surgery. Toronto: BC Decker; 1986.
Gahbauer HW, Yanagisawa K, Yanagisawa E. Head and neck radiology. In: Lee KJ, ed. Essential Otolaryngology: Head and Neck Surgery. 7th ed. Norwalk, CT: Appleton & Lange; 1998.
Kodama T. [Temporal bone imaging]. Nippon Igaku Hoshasen Gakkai Zasshi. Sep 2000;60(11):549-59. [Medline].
Levenson MJ, Michaels L, Parisier SC, et al. Congenital cholesteatomas in children: an embryologic correlation. Laryngoscope. Sep 1988;98(9):949-55. [Medline].
Michaels L. Biology of cholesteatoma. Otolaryngol Clin North Am. Oct 1989;22(5):869-81. [Medline].
Proctor B. Cavities of the temporal bone. In: Surgical Anatomy of the Ear and the Temporal Bone. vol 1. New York, NY: Thieme Medical Publishers; 1989:39-85.
Ruben RJ. The disease in society: evaluation of chronic otitis media in general and cholesteatoma in particular. In: Sade J, ed. Cholesteatoma and Mastoid Surgery. Amsterdam: Kugler Publications; 1982.
Strunk CL. Cholesteatoma. In: Bailey BJ, Johnson JT, Newlands, SD, eds. Head and Neck Surgery--Otolaryngology. vol 2. Philadelphia, Pa: Lippincott Williams & Wilkins; 1993:1635-1646.
Swartz JD, Harnsberger HR. The middle ear and mastoid. In: Imaging of the Temporal Bone. 3rd ed. New York, NY: Thieme; 1998:47-169.
Williams MT, Ayache D, Alberti C, et al. Detection of postoperative residual cholesteatoma with delayed contrast-enhanced MR imaging: initial findings. Eur Radiol. Jan 2003;13(1):169-74. [Medline].
Further Reading
Keywords
keratoma, congenital cholesteatoma, primary acquired cholesteatoma
