The CT scan reveals opacification of the mastoid air cells (red arrow) on the right consistent with chronic

mastoiditis. Acute mastoiditis is a rare complication of otitis media while chronic mastoiditis is associated with
chronic suppurative otitis media or cholesteatoma formation. The pneumatized mastoid air cells become filled
with mucopurulent debris, which leads to demineralization of the surrounding bone and potential abscess
formation.

An axial CT image from a patient with acute mastoiditis demonstrates fluid in the mastoid air cells (yellow arrow)
and soft-tissue swelling of the external auditory canal (white arrows). In early mastoiditis, osseous resorption has
not yet occurred. Patients with acute and chronic mastoiditis are at risk of developing serious complications
including epidural abscess, dural venous thrombophlebitis, or subdural empyema. Aggressive therapy is needed,
usually with a combination of antimicrobial therapy and surgical drainage, to avert these serious complications

MRI