Which of the following imaging findings on high-resolution CT temporal bone is most specific for differentiating cholesteatoma from granulation tissue or mucosal disease in a patient with CSOM?
- A Bony erosion of the ossicles or scutum with a soft tissue mass ✓
- B Soft tissue opacification of the mastoid air cells
- C Fluid density in the middle ear cleft
- D Thickening of the tympanic membrane
Correct answer: A. Bony erosion of the ossicles or scutum with a soft tissue mass
Explanation
Bony erosion, particularly of the scutum, ossicles, or tegmen, in the presence of a soft tissue mass is the most specific CT finding for cholesteatoma. Soft tissue opacification, fluid, and tympanic membrane thickening are nonspecific and can be seen in mucosal disease and granulation tissue. Bone erosion is the hallmark that distinguishes cholesteatoma from non-erosive CSOM.
Reference: Diagnostic Imaging: Head and Neck, 4th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.