Pneumoparotid

Discussion:

The CT scan demonstrated features consistent with the patient's presentation of left otitis externa and surrounding cellulitis. There was no CT evidence of left mastoiditis as queried by the clinician.

However, there was an incidental finding of bilateral pneumoparotid. This is not related to the inflammatory changes on the left side of the face as the pneumoparotid changes are seen bilaterally.

Pneumoparotid is rare; nevertheless, it is associated with elevated oral positive pressures such as in glassblowers, underwater divers and Valsalva maneuver. 

On further history-taking, it was noted that this patient performs Valsalva to pop his ears multiple times a day.

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