Which of the following features on high-resolution CT (HRCT) mastoid is MOST specific for erosive cholesteatoma versus mucosal CSOM?
- A Opacification of the mastoid air cells
- B Blunting of the scutum (bone erosion of the lateral attic wall) ✓
- C Sclerosis of the mastoid
- D Retraction of the tympanic membrane
Correct answer: B. Blunting of the scutum (bone erosion of the lateral attic wall)
Explanation
Erosion or blunting of the scutum (lateral wall of the epitympanum/spur of Henle) on HRCT mastoid is the earliest and most specific CT sign of cholesteatoma. It reflects the initial bony erosion caused by the attic retraction pocket. Opacification and sclerosis are non-specific findings seen in both mucosal CSOM and cholesteatoma. Tympanic membrane retraction is a clinical finding, not a CT feature.
Reference: Dhingra Diseases of Ear, Nose and Throat, 7th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.