Detection of Cholesteatoma Using Diffusion Magnetic Resonance Imaging

Status Not yet recruiting

Clinical Trial Summary

Cholesteatoma is a retraction pocket lined with squamous epithelium lined with keratin debris occurring within pneumatized spaces of the temporal bone. Cholesteatomas have a propensity for growth, bone destruction, and chronic infection.High-resolution computerized tomography is the method of choice for imaging the middle ear .

Clinical Trial Description

In patients with recurrent cholesteatoma, computerized tomography can show the extent of cholesteatoma in relation to the ossicles and mastoid process,but computerized tomography has a high negative predictive value if neither a soft-tissue mass nor bony destructions are shown.However, if a soft-tissue mass in the middle ear is seen on computerized tomography, diagnosis of the mass is not possible because cholesteatoma, mucoid secretion, granulation tissue and cholesterol granuloma can not be differentiated from one another on computerized tomography.

Standard magnetic resonance imaging shows tissues better than computerized tomography,Therefore in patients with cholesteatoma, magnetic resonance imaging plays a complementary role to computerized tomography in the diagnostic workup, Although computerized tomography provides excellent Bony resolution for showing the anatomy, magnetic resonance imaging provides specificity in characterizing soft-tissue abnormalities shown on computerized tomography,How ever standard magnetic resonance imaging frequently fails to allow differentiation of cholesteatoma from other soft tissues or mucoid secretions, particularly in patients who had ear surgery.

Recent studies of diffusion weighted magnetic resonance imaging show that it is sensitive to cholesteatoma tissue.Recent studies highlights the ability of diffusion weighted magnetic resonance imaging in differentiating cholesteatoma from granulation tissue in patients who have undergone mastoidectomy and also these imaging modalities help in the diagnosis of residual cholesteatoma. Diffusion weighted magnetic resonance imaging play an important role in diagnosis of retraction pockets .

Diffusion weighted magnetic resonance imaging is based on the principle of random microscopic motion (Brownian motion) of water molecules.This "diffusion" of water molecules differs in each biological tissue, For example water molecules in cholesteatoma are less mobile giving rise to a hyper-intense signal, while in other tissues as granulation tissues, water molecules are more mobile thus appear less intense on diffusion weighted magnetic resonance imaging sequence. ;

Study Design

Related Conditions & MeSH terms

Cholesteatoma

Clinical Trial Details

NCT number	NCT03305796
Study type	Observational
Source	Assiut University
Contact	ahmed Abdel-Aleem, professor
Phone	01222892745
Email	abduleen@aun.edu.eg
Status	Not yet recruiting
Phase	N/A
Start date	November 2017
Completion date	February 2019

View Details

See also
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Recruiting	`NCT05921643` - Short- and Medium-term Evaluation of Mastoid Filling Using Bioactive Glass"
Completed	`NCT06016335` - MRI-based Synthetic CT Images of the Head and Neck	N/A
Active, not recruiting	`NCT03294421` - Combined Access Closed Tympanomastoidectomy: Microsurgery Allied to Endoscopy	N/A
Completed	`NCT01855425` - Cone Beam CT for Diagnosis of Select Otorhinolaryngology (ENT) Indications at Lower Dose	N/A
Not yet recruiting	`NCT06424704` - Chronic Suppurative Otitis Media Microbiology
Recruiting	`NCT03954288` - The Serum Sclerostin Levels in Cholesteatoma Patients
Completed	`NCT04959539` - Endoscopic Transcanal Tympanoplasty With Attico-antrostomy Versus Endoscopic-assisted Canal Wall up Mastoidectomy in Management of Localized Cholesteatoma: A Randomized Clinical Trial	N/A
Active, not recruiting	`NCT00270660` - A Study of the Clinicopathologic Behaviour of the Different Types of Unsafe Chronic Otitis Media	Phase 3
Recruiting	`NCT03915392` - Diffusion Weighted MRI Accuracy in Cholesteatoma Localization
Completed	`NCT00682409` - Magnetic Resonance (MR) Imaging in the Post Operative Follow-up of Cholesteatoma in Children	N/A
Completed	`NCT01638052` - Great Auricular Nerve Block for Children Undergoing Tympanomastoid Surgery	Phase 2
Completed	`NCT02019888` - Wide Frequency Band Test of Hearing in Veterans
Recruiting	`NCT02903550` - Usefulness of Non EPI-DWI-MRI / CT 3D Static Co-registration Prior to Surgery of Cholesteatomas	N/A

Clinical trials are conducted in a series of steps, called phases - each phase is designed to answer a separate research question.

Phase 1: Researchers test a new drug or treatment in a small group of people for the first time to evaluate its safety, determine a safe dosage range, and identify side effects.
Phase 2: The drug or treatment is given to a larger group of people to see if it is effective and to further evaluate its safety.
Phase 3: The drug or treatment is given to large groups of people to confirm its effectiveness, monitor side effects, compare it to commonly used treatments, and collect information that will allow the drug or treatment to be used safely.
Phase 4: Studies are done after the drug or treatment has been marketed to gather information on the drug's effect in various populations and any side effects associated with long-term use.