Acute Complex Otomastoiditis Superimposed on Cholesteatoma 1, CT
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This CME activity consists of the student reviewing the video of the professor reviewing the case as well as the associated DICOM image set related to the case in question.
Learning Objectives
As a result of participation in this activity, participants should be able to:
- Provide improved patient care.
- Greater knowledge of the imaging characteristics of the patient's disease.
- Understand a better approach to interpretation of studies.
Faculty Disclosure
Mehmet Albayram, MD, Ivan Davis, MD, Mariam Hanna, MD, Anthony Mancuso, MD, Ronald Quisling, MD, Dhanashree Rajderkar, MD, Priya Sharma, MD, Roberta Slater, MD and Joann Stamm, MBA have disclosed that they have no relevant financial relationships. No one else is a position to control content have any financial relationship to disclose.
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Conflict of interest information for the CME Advisory Committee members can be found on the following website: https://cme.ufl.edu/disclosure/.
Continuing Medical Education Credit
Accreditation: The University of Florida College of Medicine is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.
Credit: The University of Florida College of Medicine designates this enduring material for a maximum of 0.5 AMA PRA Category 1 Credits. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
CA0105-Acute Complex Otomastoiditis Superimposed on Cholesteatoma 1, CT
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CA0105-Acute Complex Otomastoiditis Superimposed on Cholesteatoma 1, CT
Case ReportHistory
Exam
Findings
Extracranial Structures
There is extensive edema/cellulitis surrounding the pinna, periauricular soft tissues, parotid gland or masticator and parapharyngeal spaces on the right side.
Right Temporal Bone
External auditory canal shows some soft tissue thickening without bone erosion, especially along the roof.
There is extensive mucosal thickening throughout the middle ear and mastoid. The external cortex of the mastoid process is eroded but there is no related subperiosteal abscess. The mastoid septae and sigmoid plate of the mastoid are eroded consistent with aggressive otomastoiditis of a coalescent type.
There is a possible early subperiosteal/epidural abscess along the sigmoid plate of the mastoid not obviously displacing the adjacent sigmoid sinus.
The malleus and incus are eroded, the incudostapedial joint is not intact but the entire stapes does appear to be present and intact.
The facial canal and nerve are dehiscent; this could be a normal anatomic variation, since the same findings are present on the left, or its appearance could be due to erosion.
The air cells at the petrous apex are filled with fluid and/or mucosal thickening but without evidence of bone erosion.
The inner ear is possibly abnormal with bone over the lateral aspect of the lateral semicircular canal very thin and likely focally completely dehiscent.
Left Temporal Bone
The left temporal bone is normal.
Intracranial
There are no significant intracranial complications either infectious or vascular. There is no evidence of hydrocephalus or meningitis.
