Advanced Necrotizing Otitis Externa, CT
Claim CME CreditPOINT OF CARE INFORMATION
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.
CME Advisory Committee Disclosure:
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.
CA0290-Advanced Necrotizing Otitis Externa, CT
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CA0290-Advanced Necrotizing Otitis Externa, CT
Case ReportHistory
Exam
Prior Study
Findings
Extracranial Soft Tissues
There is left-sided soft tissue swelling involving the pinna, periauricular soft tissues, parotid gland nasopharynx and subjacent masticator, and parapharyngeal retropharyngeal and prevertebral spaces. There are no localized fluid collections.
General Skull Base
The clivus, petrous apex inferior surface and floor of the middle cranial fossa are eroded and their marrow spaces infiltrated on the left.
Cavernous Sinus and Paracavernous Structures
There is no structural abnormality along course of the fifth cranial nerve rootlets, ganglion and/or major divisions within and adjacent to the cavernous sinus as best that can be determined on this noncontrast study.
Right Temporal Bone
The right temporal bone is normal.
Left Temporal Bone
The external auditory canal shows abnormal soft tissue thickening. The walls are eroded with the erosion extending to involve the petrotympanic fissure and spreading along the anterior-inferior aspect (extracranial aspect) of the petrous apex involving the bony Eustachian tube and carotid canal.
There is middle ear and mastoid mucosal disease/fluid. The roof of the mastoid and middle ear, mastoid septae and sigmoid plate are not eroded. There is bone erosion along the outer margin of the mastoid portion of the temporal bone.
The ossicles, in particular the incus long process, the incudostapedial joint and stapes are not eroded or displaced. The facial canal is normal. The inner ear, in particular the lateral semicircular canal and the cochlea are not eroded or otherwise abnormal.
Intracranial
There is no evidence of subperiosteal, subdural or epidural abscess brain edema and/or evolving abscess present or, specifically, involving the inferior temporal lobe or adjacent cerebellum as best that can be determined on this noncontrast study.
There is no evidence of thrombosis, thrombophlebitis or other occlusive or inflammatory process of the sigmoid sinus, transverse sinus, the vein of Labbe’ or jugular bulb or vein as best that can be determined on this noncontrast study. The erosive process does extend toward the jugular fossa.
