Proposal of a magnetic resonance imaging follow-up protocol after cholesteatoma surgery: a prospective study.

Publication/Presentation Date

6-1-2022

Abstract

BACKGROUND: Non-echo planar (EPI) diffusion-weighted (DW) MRI has become an effective tool for the follow-up after cholesteatoma surgery and decreased the rate of second-look surgeries.

OBJECTIVES: To shed light on the optimal imaging follow-up protocol to detect postoperative residual or recurrent cholesteatoma.

MATERIALS AND METHODS: 64 patients were included in this prospective study. Three different surgical procedures were considered: canal-wall-up (26 patients), canal-wall-down (20 patients), and obliterative (18 patients). The imaging follow-up protocol included non-EPI DW MRI during the following postoperative periods: 1 month, 6 months, and 1, 3, 5, and 7 years after the primary surgery.

RESULTS: MRI-positive lesions were present in 18.75% of patients. 50% of the MRI-positive findings occurred at the 1-month follow-up. The other peak of MRI positivity occurred at the 3-year follow-up. The last MRI-positive finding appeared at the 5-year follow-up.

CONCLUSIONS: The timing for the imaging protocol proposed by this prospective study to detect recidivism after cholesteatoma surgery stressed the importance of performing non-EPI DW MRI for detecting residual, though rare, disease. Likewise, extending the follow-up to a least 5 years after primary surgery was also recommended to detect any recurrent cholesteatoma that would appear unlikely to be present beyond this time set.

Volume

142

Issue

6

First Page

484

Last Page

490

ISSN

1651-2251

Disciplines

Medicine and Health Sciences

PubMedID

35787729

Department(s)

Department of Surgery

Document Type

Article

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