Neuro_CT_Temporal_Bone: 13 M, ear pain and swelling.

CT TEMPORAL BONES WITHOUT CONTRAST:

CLINICAL HISTORY: 13 years of age, Male, Left ear pain, swelling.

FINDINGS:

Within the visualized brain, there is thrombosis of the left transverse and sigmoid sinus partially visualized.

RIGHT TEMPORAL BONE:

The external auditory canal is intact.

The tympanic membrane is preserved.

The scutum is intact.

The middle ear cavity is clear.

The ossicles (malleus, incus, and stapes) are intact.

The cochlea is preserved.

The vestibule is intact.

The semicircular canals (superior, lateral, and posterior) are intact.

The vestibular aqueduct is not enlarged.

The facial nerve canal is without abnormality.

The internal auditory canal is preserved.

The mastoid air cells are clear.

The tegmen demonstrates no dehiscence.

The skull base foramina are intact.

LEFT TEMPORAL BONE:

The external auditory canal is intact.

The tympanic membrane is not well visualized.

There is near complete opacification of the left mastoid and middle ear cavity, with osseous erosion of the mastoid septa and medial cortex. The scutum is blunted.

There is erosion of the middle ear ossicles. There is also a defect of the tegmen.

There is adjacent subcutaneous soft tissue swelling as well as a fluid collection in the retromastoid subcutaneous scalp, suspicious for subperiosteal abscess.

The cochlea (basal turn, middle turn, apical turn) is preserved.

The vestibule and semicircular canals are visualized, although there may be erosion of the vestibule and lateral semicircular canal. 

The vestibular aqueduct is not enlarged.

The facial nerve canal is visualized.

The internal auditory canal is preserved.

The skull base foramina are intact.

Impression: 

IMPRESSION:

1.  Findings are consistent with left otomastoiditis/osteomyelitis with adjacent subperiosteal abscess. Osseous erosion as described above.

2.  Thrombosis of the left transverse and sigmoid sinus partially visualized, and better characterized on subsequent MRI.

3.  Otherwise no acute intracranial abnormality within the visualized brain.

(Otomastoiditis and subperiosteal abscess)