Cholesteatoma Diagnosis depends on the its high keratin content of which makes them highly hyperintense at high b value (800-1000 sec/mm2) and with low values on apparent diffusion coefficient (ADC) map similar to that of brain parenchyma which is the same signal characteristics of intracranial epidermoid cysts. Diagnosis of recurrent cholesteatoma in an operated middle ear cavity may be difficult. HRCT scan and conventional MRI have low specificity when it comes to differentiating granulation tissue from relapsing cholesteatoma due to lack of characterization of the detected soft tissue in the surgical cavity. DWI MRI accurately differentiates recurrent cholesteatoma from infected post operative granulation tissue avoiding unnecessary second look operations. Two distinct sequences can be used for DW-MRI in the evaluation of cholesteatoma: echo-planar images (EPI) and non-echo-planar images (non-EPI).

AIM OF THE WORK:
The aim of this study was to analyse the value of different diffusion weighted magnetic resonance techniques in the diagnosis of middle ear cholesteatoma.