Ice cream cone sign (middle ear ossicles)

Last revised by Wedyan Yousef Alrasheed on 11 Jul 2023

The ice cream cone sign describes the normal appearance of the middle ear ossicles on axial CT scan. The ball of the ice cream is formed by the head of the malleus and cone is formed by the body of the incus, with the tapering conical point formed by the short process pointing towards the aditus ad antrum.

Failure of this normal configuration suggests ossicular chain disruption (incudomalleolar disarticulation).

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