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Factors affecting the correlation between high-resolution computed tomography and operative findings in cholesteatoma surgery – a systematic review

Published online by Cambridge University Press:  29 July 2025

G. Finch ,
S. Patel Open the ORCID record for S. Patel [Opens in a new window] ,
B. Walters Open the ORCID record for B. Walters [Opens in a new window]  and
M. Trotter
G. Finch
Affiliation:
Department of Otolaryngology, University Hospitals Coventry and Warwickshire NHS Trust, UK
S. Patel*
Affiliation:
Department of Otolaryngology, Queen Elizabeth Hospital Birmingham, UK
B. Walters
Affiliation:
Department of Paediatric Surgery, Sheffield Children’s Hospital, UK
M. Trotter
Affiliation:
Department of Otolaryngology, University Hospitals Coventry and Warwickshire NHS Trust, UK
*
Corresponding author: S. Patel; Email: s.patel9@doctors.org
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Abstract

Objective

Cholesteatoma is a pathological growth of squamous epithelium in the middle ear and mastoid. Pre-operative high-resolution computed tomography is commonly performed to guide the surgical approach and evaluate disease extent. The purpose of this review is to demonstrate the level of correlation between high-resolution computed tomography and intra-operative findings during cholesteatoma surgery.

Method

Medline, Embase and Cochrane databases were searched in December 2024 for studies comparing high-resolution computed tomography and intra-operative findings of adult patients diagnosed with cholesteatoma.

Results

Out of 2514 abstracts identified, 15 were included. The correlation between pre-operative high-resolution computed tomography and intra-operative findings was strongest for the identification of erosion of the malleus (k = 0.77), followed by the lateral semicircular canal and tegmen tympani (k = 0.69). The weakest correlation was found for facial nerve dehiscence (k = 0.55).

Conclusion

High-resolution computed tomography is useful for providing a roadmap for surgery. It offers a strong correlation for intra-operative detection of malleus, incus, lateral semicircular canal and tegmen tympani involvement.

Keywords

CholesteatomaComputerised tomographyFacial nerveImagingTraining

Information

Type
Review Article
Information
The Journal of Laryngology & Otology , Volume 140 , Issue 1 , January 2026 , pp. 2 - 11
Copyright
© The Author(s), 2025. Published by Cambridge University Press on behalf of J.L.O. (1984) LIMITED.

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