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Tuesday, August 4, 2015
Ear, Nose, and Throat Disorders
Opacification of mastoid
Hi, I am a 44 year old female that has been having occasional ear pain in my left ear. I only have pain if I do not wear a hat in cool/breezy weather. Otherwise, I do not have symptoms. My ear looks perfectly normal at exam. I went to see an ENT to get a ear mold made so I don`t get water in the ear and she wanted to see my MRI that I had done 3 years ago for migraine headaches. She noticed on the MRI a spot about the size of a thumbnail on my mastoid in the left ear and ordered a CT scan the next day. After the CT scan she said the spot was still there and wants to perform surgery to drain the spot and biopsy it for cancer. I am scared. I received the CT scan findings and this is what they say: Opacification of the most posterior mastoid air cell measuring up to 15 mm. There is thickening of the septa. Findings suggest the sequela of chronic mastoiditis. There is no bone destructive change to suggest a cholesteatoma. The remainder of the mastoid sinuses are clear. What are your thoughts of this? Do you think surgery is needed as I have had this for years now and no growth in spot and no other symptoms other than ear pain when I go outside without a hat. I am not wanting to jump into a surgery if there are other options. She doesn`t seem like she wants to try anything else. Thanks for your thoughts.
I think it is reasonable for you to get a second opinion. I recommend seeing an otologist / neurotologist.
Your ear pain may be due to other things, such as TMJ dysfunction.
I think the likelihood of your having a cancer in the mastoid is low, but not zero.
Even after getting a 2nd opinion, you may still need surgery. However, there clearly may be other options.
Ravi N Samy, MD, FACS
Assistant Professor of Otolaryngology, Director of Skull Base Surgery Fellowship, Director of Adults Cochlear Implantation Program
College of Medicine
University of Cincinnati