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1 results

  • Cartilage grafts mimicking cholesteatoma recurrence on diffusion-weighted magnetic resonance imaging: a case series

  • H Walters, L Lee-Warder, Y Mentias, P Arullendran
  • Journal:
    The Journal of Laryngology & Otology / Volume 137 / Issue 8 / August 2023
    Published online by Cambridge University Press:
    08 February 2023, pp. 938-941
    Print publication:
    August 2023
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  • Background

    Cholesteatomas present a high risk for residual and recurrent disease, and the surveillance of post-operative patients can be challenging. Diffusion-weighted magnetic resonance imaging is becoming the preferred method for investigating recidivism; however, false positive imaging findings increase the risk of patients undergoing unnecessary second look surgery.

    Case reports

    This study reports two patients with false positive diffusion restriction associated with cartilage grafts that mimicked cholesteatoma and resulted in second look surgery with no disease found at operation. This study also discusses the related medical literature, including potential causes of abnormal diffusion restriction and methods to negate this.

    Conclusion

    Caution should be exercised when considering second look surgery in the presence of a cartilage graft and a high confidence of disease clearance. A multi-disciplinary approach is recommended for the operating surgeon to review the images with a radiologist.