Chronic otomastoiditis

Case contributed by Dr Dalia Ibrahim


Chronic left ear pain, obstruction and discharge.

Patient Data

Age: 35 years
Gender: Male

Opacification of the left middle ear cleft and mastoid air cells with soft tissue, associated with middle ear atelectasis, 

Tympanic membrane thickening and retraction.

No bony erosion. (which differentiates it from cholesteatoma)

Intact scutum, ossicles and tegmen tympani. 

Additional examination of the nasopharynx & paranasal sinuses revealed enlarged nasopharyngeal adenoids.

Note the enlarged nasopharyngeal adenoids on the scout

Case Discussion

Chronic otomastoiditis (COM) should be considered a separate entity from acute otomastoiditis, and is thought to be primarily due to Eustachian tube dysfunction as demonstrated in this case secondary to enlarged nasopharyngeal adenoids. 

Chronic otomastoiditis (COM) is persistent or recurrent inflammation of the middle ear and mastoid air cells lasting for a minimum of 12 weeks.

The term encompasses a number of conditions:

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Case information

rID: 42631
Published: 1st Feb 2016
Last edited: 2nd Oct 2019
System: Head & Neck
Inclusion in quiz mode: Included

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