Findings:
Right side:
Soft tissue densities noted within the right middle ear cavity overlaying both window niches and extending cranially to the epitympanic recess. Minimal soft tissue density is also seen in the Prussak space without any obvious bony erosions. The tegmen tympani and the scutum are intact. The ossicles are unremarkable. The tympanic membrane is retracted.
Partial obliteration of the mastoid air cells is seen 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.
High riding jugular bulb is seen on the right side.
Left side:
Soft tissue density within the left middle ear cavity, which extends from the epitympanum to the hypotympanum. No obvious erosion of the tegmen tympani, the scutum or the ossicles. The tympanic membrane is retracted. Near opacification of the mastoid air cells on the left is seen.
The external auditory canal, vestibular-cochlear apparatus and internal acoustic canal have a normal appearance. The vestibular aqueduct is normal size.
Hyperostosis frontalis interna is seen. The paranasal sinuses are clear.
Conclusion:
Features most likely in keeping with bilateral chronic otomastoiditis. No obvious bony erosions to indicate cholesteatoma.
In case of clinical suspicion further evaluation with HASTE DW-MRI is advised.