Acute otitis media: bulging tympanic membrane

Case contributed by Dr Chris O'Donnell

Presentation

Severe right ear pain and tenderness over the right mastoid process ? mastoiditis

Patient Data

Age: 6
Gender: Male
CT

Limited non-contrast CT through the petrous temporal bones

Fluid in the middle ear cleft on the right as well as the mastoid antrum and mastoid air cells.  No overlying soft tissue swelling nor bone erosion to indicate osteomyelitis/gross mastoiditis. Note bulging of the upper tympanic membrane (pars flaccida) due to raised pressure in the tympanic cavity with pulling in at the umbo ie the malleolal attachment. Note the inferior pars tensa portion of the membrane does not bulge as dramatically as the upper flaccida.

Note bulging of the upper tympanic membrane (pars flaccida) due to raised pressure in the tympanic cavity (arrow) with pulling in at the umbo ie the malleolal attachment.

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Case information

rID: 28253
Case created: 17th Mar 2014
Last edited: 3rd Nov 2015
System: Head & Neck
Inclusion in quiz mode: Included

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