ABSTRACT
BACKGROUND: Cholesteatomas present a high risk for residual and recurrent disease, and the surveillance of post-operative patients can be challenging. Diffusion-weighted magnetic resonance imaging is becoming the preferred method for investigating recidivism; however, false positive imaging findings increase the risk of patients undergoing unnecessary second look surgery. CASE REPORTS: This study reports two patients with false positive diffusion restriction associated with cartilage grafts that mimicked cholesteatoma and resulted in second look surgery with no disease found at operation. This study also discusses the related medical literature, including potential causes of abnormal diffusion restriction and methods to negate this. CONCLUSION: Caution should be exercised when considering second look surgery in the presence of a cartilage graft and a high confidence of disease clearance. A multi-disciplinary approach is recommended for the operating surgeon to review the images with a radiologist.
Subject(s)
Cholesteatoma, Middle Ear , Humans , Cholesteatoma, Middle Ear/diagnostic imaging , Cholesteatoma, Middle Ear/surgery , Diffusion Magnetic Resonance Imaging/methods , Magnetic Resonance Imaging , Magnetic Resonance Spectroscopy , Recurrence , Sensitivity and Specificity , Female , Middle AgedABSTRACT
Neoplasms of the head and neck most commonly seen within the larynx are likely malignant and epithelial in origin. Although uncommon, non-epithelial types are occasionally encountered in clinical practice. Owing to the rare nature of these entities, they can lead to diagnostic and treatment uncertainty. We present our two-centre experience of nine different types of non-epithelial laryngeal tumours in this review, highlighting characteristic imaging features and discussing the recommended management strategies emerging.
