Findings:
Opacification of the right mastoid and middle ear with high signal on T1 and T2.
On DWI imaging an approximately 1 cm measuring focus of diffusion restriction is noted in the right attic with extension along the roof of the right external auditory canal. Soft tissue thickening is seen in the right external auditory canal.
No abnormality is seen on the left side.
The vestibular-cochlear apparatus and internal acoustic canals have a normal appearance. No structural cochlear abnormalities.
The facial and vestibulocochlear nerves have a normal appearance. The trigeminal and abducens nerves are normal.
The imaged brain is unremarkable.
The paranasal sinuses and the mastoid air cells on the left are clear. Prominent nasopharyngeal adenoid is seen.
Conclusion:
Recurrent cholesteatoma in the right attic extending along the roof of the right external auditory canal. Further evaluation with CT petrous mastoid bones is advised.