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Abstract
HRCT detects bone erosion as mastoid cell erosion, tegmen, ossicles, lateral sinus plate, lateral semicircular canal, facial nerve canal with high degree of accuracy. HRCT detects intracranial complications with high degree of accuracy. Soft tissue masses in the middle ear and mastoid; there was an agreement in 90% between CT findings and surgical findings. 5% of cases showed false +ve results and 5% of cases showed false –ve results. HRCT cannot differentiate cholesteatoma from other soft tissue masses, especially in the presence of bone loss. MRI was done for 8 patients and we correlated MRI findings with surgical finding to differentiate cholesteatoma from non-cholesteatoma. There was an agreement in 100% between MRI findings and surgical findings. On surgery, 6 cases showed cholesteatoma which proved by MRI as hypo-intense in T1 delayed postcontrast image and hyperintense in diffusion weighted image. Two cases showed granulation lesions which proved by MRI as hyper-intense in T1 delayed postcontrast image and hypo-intense in diffusion-weighted image. Postoperative CT scanning and when needed MRI is very useful in the follow-up of the patients for middle ear surgery for CSOM and prior to revision surgery as it may eliminate the need for a second operation and it will be useful as it helps to prevent serious surgical complications.