Investigation of choice for cholesteatoma:
Ans. d (HRCT temporal bone). (Ref. Diseases of ENT, PL Dhingra, 3rd ed., 94)HRCT delineates extent of bone destruction, degree of mastoid pneumatization, status of dural and sinus plates, plates with low lying dura or an anteposed sigmoid sinus (useful when operative treatment is being contemplated) and complications if any in a highly better fashion than a Schuller's view of mastoid. Cholesteatoma causes destruction in key areas of attic and antrum, which is better seen in lateral view, however HRCT temporal bone gives more precise and greater detailed information.
Schuller's view X-ray
Otoscopy
Skull X-ray, lateral view
HRCT temporal bone
CSOM and its Complications