1. OTITIS MEDIA Prof. Mahmoud El Samaa Prof. of ENT, HN Surgery
Ain Shams University

2. FLUID

3. CHOLESTEATOMA
the
Dangerous Ear

4. MRI CT scan T2 T1+ gad T1 contrast density Lesion    Schwannoma 
CT & MRI Characteristics T2
T1+ gad T1
contrast
density
Lesion   
Schwannoma 
Vascular
Cholesteatoma
CSF cyst
Cholesterol granuloma

5. CHOLESTEATOMA

6. CHOLESTEATOMA Scutal Erosion

7. ATTIC CHOLESTEATOMA
Bone window
Soft tissue window

8. Attic retraction sac with
intact malleus
Attic & mesotympanal cholesteatoma
Ossicles erosion (malleus & stapes)

9. Cholesteatoma cavity with sequestrum
Attic Cholesteatoma 
Cholesteatoma cavity with
sequestrum

10. Huge Cholesteatoma

11. COMPLICATIONS

12. Sinus plate erosion
AXIAL CUT    
CORONAL CUT

13. Tegmen Erosion
CORONAL
AXIAL

14. Mastoid Cortex erosion
Erosion of cortex &
sinus plate

15. hypodense subcutaneous collection
MASTOID ABSCESS
Soft tissue window:
hypodense subcutaneous collection

16. Cholesteatoma, with exposure of facial nerve in tympanic portion
Cholesteatoma, no exposure of facial nerve in tympanic portion

17. BUT?? Bone window: Cholesteatoma cavity Soft tissue:
Cerebellar abscess

18. Bone Window
Soft tissue window

19. Cerebellar abscess
MRI

20. CT with extensive bone erosion, reaching to petrous apex & eroding SCC
Bezold Abscess
CT with extensive bone erosion,
reaching to petrous apex & eroding SCC

21. AXIAL MRI T1: hypointense T1 Gd: hyperintense=pus
T2: heterogenous (pus)

22. CORONAL MRI T2 T1Gd T2: showing the track of extension of infection
beneath sheath of
sternomastoid

23. Value of imaging in cholesteatoma:
diagnosis
extent
lateral canal or cochlear fistula
intracranial complications
erosion of walls of middle ear and mastoid
relation to facial nerve

24. DIABETIC EAR

25. Serious Condition

26. Cholesterol Granuloma
Petrous Apex
Cholesterol Granuloma