Findings:
Loss of right middle ear ossicular chain (only parts of malleolus are identifiable), as well as bony septae of mastoid air cells with subsequent formation of one cavity, which shows internal soft tissue and air densities. Soft tissue densities also seen within the right middle ear cavity, expanding the Prussak space, eroding scutum. The tegmen tympani is intact.
Some foci of calcification are also noted in the right mesotympanum in the fossa of oval window.
The tympanic membrane on the right side is retracted and thickened.
Lateralised sigmoid sinus is noted on the right side.
The external auditory canal, vestibular-cochlear apparatus and internal acoustic canal have a normal appearance. The vestibular aqueduct is normal size.
The course of the facial nerve is normal.
Partial obliteration of the mastoid air cells is seen on the left side. The middle and inner ear structures on the left are unremarkable.
No focal bony abnormality is identified in the skull base.
Mild mucosal thickening is seen in the imaged maxillary and ethmoid sinuses bilaterally.
Conclusion:
Features consistent with right-sided middle ear cholesteatoma with ossicular chain and scutum erosion. Previous right-sided canal wall up mastoidectomy/automastoidectomy.
Partial obliteration of the mastoid air cells on the left side.