الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
This study Included 56 consecutive patients with chronic
suppurative otitis media unsafe type ”cholesteatomas” presented with ear
dicharge, conductive hearing loss, facial paresis scan by signs of
increased intra cranial tension or vertigo .
Each patient is subjected to full clinical Evaluation , high
Resolution CT examination Intravenous contrast media was used in
some patients with suspected intra cranial complication. Pre-operative
Radiological data was correlated with data of surgicall finding . and this
is agreed with other studies in this regard.
Middle ear cholesteatoma is a common problem. A cholesteatoma
can be dangerous and should never be ignored. Bone erosion can cause
the Infection to spread into the surrounding areas including the inner ear
and brain. If untreated hearing loss and intracranial complication may
occur. Acquired cholesteatomas commonly seen in patients less than 30
years. there is atypical history of Recurrent middle ear infections with
tympanic membrane perforation.
The diagnosis of cholesteatoma is usually made on otologic
examination.
Cholesteatoma can be accurately diagnosed by the HRCT scan in
the vast majority of cases.
CT diagnosis of cholesteatoma based on three criteria; the
presence of tissue density mass, location typical for cholesteatoma (attic,
mesotympanum or posterior tympanum ) associated with bony erosion of
middle ear bony boundries, ossicular chain or mastoid. secondary
acquired cholesteatoma was most often localized to the attic and antrum,
some are extensive. the important role of CT scan lies in the early
detection of cholesteatoma, which depends on displacement of the
ossicular chain and subtle bony erosion like blunting of the scutum. other
very important advantage of CT is the demonstration of cholesteatoma in
hidden areas such as sinus tympani and facial Recess. the differential
diagnosis of diffuse middle ear tissue density lesion is difficult by CT
scan especially in absence of definite bony erosion because
cholesteatoma, granulation tissue and middle ear effusion all share CT
numbers . the diagnosis of cholesteatoma in these patients depend on
secondary findings. MRI has a role in differentiation of soft
tissue Nature and can beneficial in these cases .