The Use of Serial Non EPI DWI MRI Scans to Determine the Growth of Cholesteatoma

Abstract

Introduction It is an established practice to use non-EPI DWI MRI scans to detect the presence of cholesteatoma post operatively. In the present era of Covid-19 where routine surgery to remove cholesteatoma has been suspended resulting in potentially unprecedented demands on the service, a review of serial MRI scans performed over a 7 year period was undertaken to determine the rate of growth of cholesteatoma. Materials and Methods A retrospective longitudinal study identified 24 middle ear cholesteatomas in 17 patients with serial non-EPI DWI MRI scans (having excluded those having surgical intervention between scans) for a median period of 33 months (range of 6-91 months). Cholesteatomas were measured by the first author and by the consultant radiologist. Results Of 24 cholesteatomas, 1 resolved completely, 5 reduced, 6 stayed the same size, 4 grew slowly and 8 grew significantly. Conclusion Non-EPI DWI MRI scans to determine cholesteatoma growth in asymptomatic ears is useful in triaging patients in the Covid-19 era.