Can MRI replace a second look operation in cholesteatoma surgery?

The purpose of this rarer is to investigate whether; a magnetic resonance i maging (MRI) examination of the petrous bonrs could replace the conventiona l second look surgical procedure when a canal wall up tympanoplasty procedu re has been performed during the first look surgery. Eighteen patients were examined with MRI prior to a second look surgical procedure. MRI was perfo rmed on a 1.5 T superconducting system. T2 weighted images before contrast and T1 weighted images after contrast (gadopentate: dimeglumine) were obtai ned. Imaging results a ere compared with surgical findings. The poor radios urgical correlation (50%! and 61% after re-evaluation) suggests that, at th e present time, MRI is not a valid alternative to a second look surgical in tervention in thr case of cholesteatoma treated by canal wall up tympanopla sty. In our study. MRI was not capable of differentiating small pearls of r esidual cholestratoma from surrounding scar tissue.