Usefulness of preoperative high resolution computed tomography in middle ear cholesteatoma.

Cholesteatoma is traditionally diagnosed by otoscopic examination and treated by explorative surgery. The need for imaging in an uncomplicated case is contentious. This study assesses the usefulness of a pre-operative high-resolution CT scan in depicting the status of the middle ear structures in the presence of cholesteatoma. Cholesteatoma is a sac of keratinising squamous epithelium in the middle ear cleft. The lesion is classically recognised by the presence of attic squames on otoscopic examination. The presence of cholesteatoma must also be suspected beneath polyps protruding from the pars flaccida or when there is a marginal tympanic membrane perforation or granulation. Cholesteatoma is a potentially serious condition as it can progressively enlarge and erode into neighbouring structures, giving rise to serious intracranial and extracranial complications. The patient is benefited as he has pre surgical assessment rather wait for results of surgical exploration. Forewarned about complications. The patient has a pictorial depiction of his disease and understands the need for surgical intervention and difficulty in hearing preservation. The surgeon is armed with a visual aid to preoperative counseling ,spatial orientation of disease extent and identifies problem areas prior to surgery