Background: Acquired middle ear cholesteatoma is the anomalous proliferation of keratinized, stratified squamous epithelium with properties of growth, migration and osseous erosion. High resolution computed tomographic scanning aid in the assessment of the temporal bone anatomy, soft tissue lesions, extent of involvement, bony erosions and other complications. This study was performed to understand the characteristic findings in temporal bone in acquired middle ear cholesteatoma, and to assess the prevalence of the abnormal findings, based on high resolution computed tomography (HRCT).

Materials and Methods: Cross-sectional study was conducted in 32 clinically diagnosed cases of acquired middle ear cholesteatoma, who underwent HRCT in the Department of Radiodiagnosis, Government Medical College, Thrissur, from January 2015- June 2016 whose data were collected and statistically analysed.

Results: The main finding on HRCT was nondependent soft tissue density in middle ear cavity with associated bone erosions and expansions. Soft tissue density mainly invoved the epitympannum, mastoid antrum and aditus ad antrum. It was noted in the posterior tympanic recesses also. Scutum was the commonest site of bone erosion, followed by the ossicles. Erosions were noted in critical sites like the lateral semicircular canal, tegmen, sinus plate and facial nerve canal. Mastoids were sclerotic in most cases. Features of cholesteatoma were noted in the opposite ear in few cases.

Conclusion: Acquired middle ear cholesteatoma appears in HRCT as soft tissue mass which usually erodes and expands bone, thus leading to intratemporal and extratemporal complications. Studying the HRCT images in axial, coronal and sagittal planes help in better visualisation of the abnormalities.

Keywords: Cholesteatoma; Middle Ear; Computed Tomography; Temporal Bone.

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Abhilash Babu T.G

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