الفهرس | Only 14 pages are availabe for public view |
Abstract This study Included 56 consecutive patients with chronic suppurative otitis media unsafe type ”cholesteatomas” presented with ear dicharge, conductive hearing loss, facial paresis scan by signs of increased intra cranial tension or vertigo . Each patient is subjected to full clinical Evaluation , high Resolution CT examination Intravenous contrast media was used in some patients with suspected intra cranial complication. Pre-operative Radiological data was correlated with data of surgicall finding . and this is agreed with other studies in this regard. Middle ear cholesteatoma is a common problem. A cholesteatoma can be dangerous and should never be ignored. Bone erosion can cause the Infection to spread into the surrounding areas including the inner ear and brain. If untreated hearing loss and intracranial complication may occur. Acquired cholesteatomas commonly seen in patients less than 30 years. there is atypical history of Recurrent middle ear infections with tympanic membrane perforation. The diagnosis of cholesteatoma is usually made on otologic examination. Cholesteatoma can be accurately diagnosed by the HRCT scan in the vast majority of cases. CT diagnosis of cholesteatoma based on three criteria; the presence of tissue density mass, location typical for cholesteatoma (attic, mesotympanum or posterior tympanum ) associated with bony erosion of middle ear bony boundries, ossicular chain or mastoid. secondary acquired cholesteatoma was most often localized to the attic and antrum, some are extensive. the important role of CT scan lies in the early detection of cholesteatoma, which depends on displacement of the ossicular chain and subtle bony erosion like blunting of the scutum. other very important advantage of CT is the demonstration of cholesteatoma in hidden areas such as sinus tympani and facial Recess. the differential diagnosis of diffuse middle ear tissue density lesion is difficult by CT scan especially in absence of definite bony erosion because cholesteatoma, granulation tissue and middle ear effusion all share CT numbers . the diagnosis of cholesteatoma in these patients depend on secondary findings. MRI has a role in differentiation of soft tissue Nature and can beneficial in these cases . |