Findings:
Automastoidectomy cavity is noted on the right side. Partial destruction of the ossicular chain and blunting of the scutum on the right side. The coronal images show a shell of the cholesteatoma in the epitympanum.
The mastoid air cells on the right are obliterated. The tegmen shows few frank full thickness defects.
The right tympanic membrane is retracted.
The external auditory canal, vestibular-cochlear apparatus and internal acoustic canal have a normal appearance. The vestibular aqueduct is normal size.
Minimal fluid is seen in several mastoid air cells in the left mastoid process. No further abnormalities seen on the left side.
The course of the facial nerve is normal. The carotid canal and jugular foramen are unremarkable.
The paranasal sinuses are clear. Concha bullosa is seen bilaterally, more pronounced on the right with nasal septal deviation to the left.
Moderate osteoarthritis of the TMJs is noted.
Conclusion:
Features most likely in keeping with mural cholesteatoma with automastoidectomy cavity on the right. Further evaluation with HASTE diffusion-weighted MRI images to rule out residual cholesteatoma is advised.