CHRONIC

MASTOIDITIS AND ITS

ROENTGEN PICTURE
ELFA ALFIYANI
Case 1
G. F. S., Male. Aet. 34 years. The patient's left ear was trepanned in 1915 at the age of 5. Otitic relapses
in 1935 and 1936 and an abscess in the scar in 1942. A fresh otitic relapse lasting for four months in 1944.
Roentgen examination in 1936 showed a consider- able cell systeni (incompletely trepanned or newly
formed after tre- pana tion). A chronic mastoiditis was demonstrated with a progressive thickening of
the bone trabeculae and increased density of the bone from 1936-1944. Trepanation in 1944 showed
dispersed cells with pathological content in solid bone tislsue as well as a caseation of the cell walls
around the antrum. Larger and snialler cavitations which were covered in many places by a bony
tissue, obviously newer than the surrounding bone, were found in the histological preparation.
Case 2
Fig 4 Fig 5

Fig. 4. Case 2. Left ear. Cell system with small cells, diffuselv cloudy.
Fig. 5. Case 2. Left ear. The bony trPbeculae between the cell cavities show increased density
and breadth and rough uneven contours. The previously small cell cavities have become still
smaller. No visible destruction. Chronic mastoiditis with signs of formation of new bone.
Case 3

Fig 6 Fig 7

Fig. 6. Case 3. Left ear. The cell structure is partially defective. In several places intermediate intact cell
trabeculae are thick, with uneven contours. Chronic mastoiditis with destructive and productive
changes.
Fig. 7. Case 3. Right ear. Normal roentgen finding. Picture for comparison.
case4

Fig 8 Fig 9

Pig. 8. Case 4. Left ear. The cell trabecuiae are in several places thick with rough contours. 111 the
basal part of the mastoid process a destruction almost the sizc of an almond. Chronic mastoiditis with
productive and destructive changes.
Pig. 9. Case 4. Right ear. Normal roentgen finding. Picture for comparison.
Case 5 (5) K. N., Male. Art. 29 years. Summery. As a child the patient had Iieeii tronblptl
at times with earache and discharge froin the left ear. In the. spring of 1938 he
had discharge again which lasted for a short tirnc. Clinical examination
showed a pale, indrawn scar. The roentgen picture showed signs of chronic
masloiditis which was con- firmed by the trepanation when a caseom cell
system was also found around the antrum

Fig 10 Fig 11

Fig. 10. Case 5. Left ear. Thick septa between the small cell cavities and rough contours
towards the lumina. No certain destruction visible. Chronic and productive mastoiditis.
Fig. 11. Case 5. Right ear. Normal roentgen finding. Picture for comparison.
Case 6
(6) K.G.K, Male. ilet. 47 years. Summery. After discharge. from thc left ear ninny
years ago, the patient had a recurrence of the discharge and earache ; an
exaininatioii, some days later, showed polyp and central perforation. The
roentgeu picture gave the usual picture of chronic mastoiditis. The diagnosis was
confirmed by trepanation.

Fig 12 Fig 13

Fig. 12. Case 6. Left ear. The cell walls arc thick with uneven contours aiid the cell cavities small. No
certain destruction. Chronic mastoiditis with mainly produc- tive changes.
Fig. 13. Case 6. Right ear. Normal roentgen finding. Picture for comparison.
Case 8

Fig 14 Fig 15

Fig. 14. Case 7. Left ear. Cell system of rather small extent. The cell cavities are small with thick, rough walls. A small number of
larger cells dispersed, especially near the sinus-dura angle and down towards the mastoid process. Chronic productive
mastoiditis.
Fig. 15. Case 8. Right ear. Cell system with thick and rough bony trabeculae and small cell cavities in the base of the pyramid.
In the mastoid process there are along the sinus also a number of larger cavities: large cells or destructions? Chronic
mastoiditis.
Case 9