There is no general or localized soft tissue swelling involving the pinna, periauricular soft tissues, parotid gland or subjacent masticator and parapharyngeal, retropharyngeal and prevertebral spaces on either side.

There are no localized, potentially subperiosteal, fluid or pus collection spreading along the petrous apex inferior surface and/or clivus. The clivus and the petrous apex inferior surface and floor of the middle cranial fossa are not eroded and/or their marrow space infiltrated.

There is no structural abnormality involving the cavernous sinus region or course of the fifth cranial nerve rootlets, ganglion and/or major divisions within and adjacent to the cavernous sinus as best as can be determined on a non-contrast study.

The external auditory canal shows no abnormal soft tissue thickening and is not eroded.

There is middle ear and mastoid mucosal disease/fluid and these changes are erosive along the posterior superior aspect of the mastoid from near the sino-dural angle to air cells that lie just superior and medial to the arcuate tunnel. The disease from the mastoid spreads along a posterior superior labyrinthine air cell tract to the petro-mastoid junction. Disease then continues to track to the petrous apex. The ossicles, in particular the incus long process, the incudostapedial joint and stapes are not eroded or displaced.

The mastoid septae and roof of the mastoid are eroded along the posterior superior margin of the mastoid. The sigmoid plate of the mastoid is not eroded.

There is no dural reactive change, subperiosteal, epidural or subdural abscess along the roof of the mastoid or middle ear or the superior and posterior (intracranial) surfaces of the petrous portion of the temporal bone as best as can be determined on a non-contrast study.

The facial canal is normal. The inner ear, in particular the lateral semicircular canal and the cochlea are not eroded or otherwise abnormal.

There is non-erosive middle ear and mastoid mucosal disease/fluid present. The ossicles, in particular the incus long process, the incudostapedial joint and stapes are not eroded or displaced. The facial canal, inner ear, in particular the lateral semicircular canal and the cochlea are not eroded or otherwise abnormal.

There is no subperiosteal, subdural or epidural abscess along the floor of the middle cranial fossa or along the inner (intracranial) surfaces of the petrous portion of the temporal bone or tentorium or falx cerebri as best as can be determined on a non-contrast study.

There is no likely meningitis involving the inferior temporal lobe or adjacent cerebellum or more remote meningeal sites as best as can be determined on a non-contrast study. However, the mastoid disease present could be a source of meningitis.

There is no brain edema and/or evolving abscess present or, specifically, involving the inferior temporal lobe or adjacent cerebellum as best as can be determined on a non-contrast study.

There is no obstructive hydrocephalus - either intra or extra ventricular or signs of raised intracranial pressure on the limited views of the brain available.