Optimal use of CT imaging in pediatric congenital cholesteatoma

• Published in: Auris, nasus, larynx Vol. 44; no. 3; pp. 266 - 271
• Main Authors: Kim, So Young, Kim, Hyo-Sang, Park, Min Hyun, Lee, Jun Ho, Oh, Seung Ha, Chang, Sun O, Kim, Chong Sun, Jung, Ah Young, Kim, Young Ho
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier B.V 01.06.2017
• Subjects: Child; Child, Preschool; Cholesteatoma - congenital; Cholesteatoma - diagnostic imaging; Cholesteatoma - surgery; Cholesteatoma, Middle Ear - diagnostic imaging; Cholesteatoma, Middle Ear - surgery; Congenital cholesteatoma; Effective radiation dose; Female; Humans; Infant; Male; Otolaryngology; Radiation Dosage; Retrospective Studies; Temporal Bone - diagnostic imaging; Temporal Bone - surgery; Temporal bone computed tomography; Tomography, X-Ray Computed - methods; Effective radiation dose; Temporal bone computed tomography; Congenital cholesteatoma
• ISSN: 0385-8146; 1879-1476
• DOI: 10.1016/j.anl.2016.07.009

Abstract Objective This study aimed to determine the radiation dose of temporal bone computed tomography (TBCT) to detect pediatric congenital cholesteatoma (CC), and suggests strategy for lowering perioperative radiation dose. Methods Fifty-three CC patients followed up for more than 12 months after surgery. Perioperative clinical findings and the effective radiation dose (ERD) of TBCT were investigated. Patients’ mean age at initial TBCT was 60 months; the mean follow-up period was 43 months. Results In 33 (62.3%) of 53 patients, only one TBCT was performed postoperatively. Postoperative CT imaging was performed to evaluate before second-stage ossiculoplasty, due to suspicion of CC recurrence on examinations, or as part of follow-up. When TBCT was performed on more than two occasions after surgery as a part of follow-up, there was no difference in the distribution of stage or type of CC compared to patients subjected to TBCT on less than three occasions ( p = 0.093 and p = 0.744, respectively). During the most-recent follow-up of these 53 cases, there was no CC recurrence. The mean ERD of a single TBCT was 1.2 mSv, and the mean cumulative ERD of TBCT was 2 mSv per patient. Conclusion Mean and cumulative ERD of TBCT performed in CC cases was not too high to consider radiation hazard. However, efforts to minimize the number of CT scans should be taken basically.