Acute otomastoiditis and Bezold abscess
Left ear ache and hearing loss for 2 weeks.
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Partial opacification of the left middle ear cavity, aditus ad antrum and mastoid air cells.
Partial destruction of the intervening bony septa between mastoid air cells, with cortical bony defect along the lateral aspect of left mastoid process and internal tiny bony fragments.
Adjacent proximal part of left sternocleidomastoid muscle is diffusely enlarged showing mild heterogeneous post-contrast enhancement, with rim-enhancing cystic lesion (abscess formation).
No erosions of middle ear ossicles, tegmen tympani or scutum.
In acute suppurative otomastoiditis, the infection may spread through the thin bony cortex of mastoid process to the adjacent sternocleidomastoid muscle, forming an abscess (Bezold abscess).