CT-detected masked otitis media in various clinical situations: a possible pathogenesis to be noted

Abstract

Background: To analyze a series of CT-detected masked otitis media in various clinical situations in order to remind attention to this possible pathogenesis that is easy to be overlooked. Methods: This is Case series.Charts of patients referred for different otological complaints, including ear discomforts, vertigo or facial nerve abnormality, with an intact tympanic membrane were reviewed. Complete record of clinical history and otological examinations were required. Those with High-resolution CT (HRCT) finding of masked otitis media, which seemed to be response for the patients’ complaints, were included in the analysis. Results: A total of 15 cases of CT-detected masked otitis media were included for analysis. There were 12 cases with conductive or mixed hearing loss, 11 of which were presented asopacifications or sclerosing plaques involving the ossicles in HRCT. There were 2 cases considered as complications of otitis media, including one case of vertigo and one case of facial paralysis. Opacificationswere found in the round window niche and around the facial nerve respectively in HRCT. The remaining case merely complained of earache in the retroauricular region with normal hearing results, whose HRCT revealed Opacifications in partial mastoid cells. Conclusion: Masked otitis media as a possible pathogenesis in various clinical situations should be remind enough attention to. A detailed disease history and comprehensive analysis of otological tests, especially the careful reading of the temporal HRCT, could provide important clues for the discrimination of masked otitis media.