Findings:
Previous left sided canal-wall-down mastoidectomy is noted. A well-defined soft tissue density is noted within the mastoidectomy cavity, extending along the roof of the left external auditory canal and measuring approximately 1.2 cm. No obvious enhancement, no vascular malformation.
Soft tissue density is also seen in the left tympanic cavity. The ossicular chain on the left is almost completely absent (only the handle of malleolus is visible). Foci of calcifications are noted within the left tympanic cavity, compatible with tympanosclerosis. The tympanic membrane is retracted.
The vestibular-cochlear apparatus and internal acoustic canal have a normal appearance.
No abnormality is seen on the right side.
The Circle of Willis is normal with conventional anatomy. No evidence of stenosis or aneurysm is seen.
The dural venous sinuses are normal.
The orbits and the paranasal sinuses are clear.
Conclusion:
Previous left sided canal-wall-down mastoidectomy with a well-defined soft tissue density within the resection cavity, extending into the left external auditory canal, DDX recurrent cholesteatoma, DDX cholesterol granuloma. Further evaluation with MRI HASTE diffusion-weighted sequence is advised.
No evidence of any vascular pathology.