[The use of MRI DWI-imaging in assessment of cholesteatoma recurrences after canal wall up technique].

Introduction: The use of closed technique in cholesteatoma treatment carries a significant risk of development of residual disease thus requires a second look operation in a proportion of patients. In those with no residual cholesteatoma the second surgery could be avoided.

The Aim Of The Study: was to evaluate the use of non-echo planar HASTE diffusion-weighted MR imaging in the detection of cholesteatoma in patients after canal wall up surgery due to cholesteatoma.

Material And Methods: We evaluate the results of half-Fourier-acquisition single-shot turbo-spin-echo (HASTE) diffusion-weighted magnetic resonance imaging in 18 patients after canal wall up surgery performed 6 to 20 months after primary surgery. 16 patients were operated in our center and 2 elsewhere. All the patients underwent second look surgery that verified the result of MRI scanning.

Results: MRI DWI detected 2 cholesteatomas in patients operated elsewhere and none in patients operated in our center. Four cholesteatomas were found during second look operations. Two false negatives were in 1 patient with cholesteatoma pearl of less than 2mm in diameter and in 1 patient with mural cholesteatoma. There were no false positive results.

Conclusion: Non EPI MRI DWI can be used as a screening tool to detect residual or recurrent cholesteatoma and may substitute the need of second look surgery.