Findings:
Right middle ear:
The right middle ear cavity shows complete opacification associated with attico-antral opacity, as well as opacified sinus tympani, facial recess, anterior epitympanic recess, and both window niches. There is mass effect with widening of the attic and the epitympanic recess. The mastoid air cells are opacified and hypocellular.
The tegmen tympani and the scutum are intact.
Partial loss of ossification in the right ossicular chain with thinning of the head of malleolus as well as the body and short limb of incus.
There is bulging of the right tympanic membrane.
Smooth soft tissue densities also noted along the right external auditory canal.
The course of the facial nerve is normal without any obvious bony dehiscence.
The vestibular-cochlear apparatus and internal acoustic canal have a normal appearance. The vestibular aqueduct is normal size.
The carotid canal and jugular foramen are unremarkable.
Left middle ear:
Mild, smooth soft tissue thickening is noted along the roof of the left external auditory canal without any bony erosions.
The middle ear, vestibular-cochlear apparatus and internal acoustic canal have a normal appearance. The vestibular aqueduct is normal size.
The tympanic membrane and ossicles are normal. The epitympanic recess, scutum, mastoid antrum and mastoid air cells are normal.
The course of the facial nerve is normal.
The carotid canal and jugular foramen are unremarkable.
The imaged paranasal sinuses are clear.
Conclusion:
Features are likely in keeping with the clinically diagnosed chronic suppurative otitis media with complete opacification of the right mastoid and middle ear cavity as well as partial ossicular erosion. Additional cholesteatoma cannot be ruled out. Further evaluation with HASTE DW-MRI is advised.
Chronic external otitis on the right side and possibly also on the left side. Clinical correlation is advised.