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Otomastoiditis - uncomplicated

Case contributed by Derek Smith
Diagnosis certain

Presentation

Discharge from left ear with otalgia. Recent treatment for tonsillar cancer. ?collection ?bone destruction

Patient Data

Age: 60 years
Gender: Female

Soft tissue thickening in the left external auditory canal, with periauricular soft tissue stranding.

Opacification of the middle ear cavity and mastoid air cells.

No bone erosion / destruction; EAC, TMJ, ossicles, mastoid cells all intact.

No intracranial complication; no collection, pneumocephalus, venous thrombosis.

No nodal abnormality.

Other findings:

Post radiotherapy changes in the neck; fat reticulation, fascial / platysmal thickening, gland hyperenhancement, mucosal thickening (see epiglottis on sagittal).

Case Discussion

This is a case of uncomplicated otomastoiditis. There are no features of aggressive disease, namely no bone erosion.

This case also demonstrates typical post-radiotherapy changes in the head and neck, as described in the case findings section.

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Case contributed by Dr Mark Rodrigues with thanks.

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