This meta-analysis looked at patients who had surgery for cholesteatoma. The researchers combined data from 1,187 people to see how well non-EPI DWI MRI scans worked for finding disease that came back. They compared different timing schedules for these scans against older surgical methods.
The study found that MRI positivity rates varied over time. At 12 months, the rate was 15 percent. By 24 months, it rose to 22 percent. Rates remained around 12 to 21 percent through the 60-month follow-up period. The data showed that the canal wall up procedure had higher MRI positivity rates than obliteration procedures at 12 and 36 months.
Adults showed a 16 percent positivity rate at 12 months, while children showed 20 percent. The study supports performing the first routine scan between 12 and 24 months after surgery. If the initial scan is negative, follow-up imaging can happen every two years. This approach continues for at least five years to monitor for recurrence safely.