In 100 consecutive cholesteatomas we found that microscopic otoscopy usually provided the diagnosis of cholesteatoma but gave only a suggestion of the extent of the surgical lesion. Tomography enabled us to predict the extent of the cholesteatoma in 89% of the cases. The correlation of tomographic, otoscopic, and surgical pathological findings improved when we classified cholesteatomas according to the anatomical location of the perforation of the tympanic membrane. We were able to define certain radiographic patterns for cholesteatomas associated with perforations of the pars tensa, pars flaccida, and combined perforations of the pars tensa and pars flaccida. Our study showed the usefulness and accuracy of preoperative tomographic study of cholesteatomas.
Buckingham RA, Valvassori GE. Tomographic and Surgical Pathology of Cholesteatoma. Arch Otolaryngol. 1970;91(5):464–469. doi:10.1001/archotol.1970.00770040658014