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New mastoidectomy study results from L. Migirov et al described
2009 JUN 2 - (NewsRx.com) -- According to recent research from Tel Hashomer, Israel, "Aural cholesteatoma is an epidermal cyst of the middle ear or mastoid that can be eradicated only by surgical resection. It is usually managed with radical or modified radical mastoidectomy." "Clinical diagnosis of recurrent cholesteatoma in a closed postoperative cavity is difficult. Thus, the accepted protocol in most otologic centers for suspected recurrence consists of second-look procedures performed approximately 1 year after the initial surgery. Brain herniation into a post-mastoidectomy cavity is not rare and can be radiologically confused with cholesteatoma on the high resolution computed tomographic images of temporal bones that are carried out before second-look surgery. To present our experience with meningoceles that were confused with recurrent disease in patients who had undergone primary mastoidectomy for cholesteatoma and to support the use of magnetic resonance imaging as more suitable than CT in postoperative follow-up protocols for cholesteatoma. We conducted a retrospective chart review of four patients. Axial CT sections demonstrated a soft tissue mass in the middle ear and mastoid in all four patients. Coronal reconstructions of CT scans showed a tympanic tegmen defect in two patients. CT failed to exclude chlesteatoma in any patient. Each underwent a second-look mastoidectomy and the only finding at surgery was meningocele in all four patients. Echo-planar diffusion-weighted MRI can differentiate between brain tissue and cholesteatoma more accurately than CT," wrote L. Migirov and colleagues. The researchers concluded: "We recommend that otolaryngologists avoid unnecessary revision procedures by using the newest imaging modalities for more precise diagnosis of patients who had undergone mastoidectomy for cholesteatoma in the past. IMAJ 2009;11:144-146'." Migirov and colleagues published their study in Israel Medical Association Journal (MRI, not CT, to Rule out Recurrent Cholesteatoma and Avoid Unnecessary Second-Look Mastoidectomy. Israel Medical Association Journal, 2009;11(3):144-146). For additional information, contact L. Migirov, Chaim Sheba Med Center, Dept. of Otolaryngology Head & Neck Surgery, IL-52621 Tel Hashomer, Israel. Publisher contact information for the Israel Medical Association Journal is: Israel Medical Association Journal, 2 Twin Towers, 11TH FL, 35 Jabotinsky St., PO Box 3604, Ramat GaN 52136, Israel. Keywords: Israel, Tel Hashomer, Cysts, Epidermal Cyst, Mastoidectomy, Meningocele, Radical Mastoidectomy, Surgery, Urology. This article was prepared by Life Science Weekly editors from staff and other reports. Copyright 2009, Life Science Weekly via NewsRx.com.
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