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Dr. Andrew Rynne
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Dr. Andrew Rynne

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What causes mastoid sclerosis?

Answered by
Dr.
Dr. Sumit Bhatti

ENT Specialist

Practicing since :1991

Answered : 2592 Questions

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Posted on Fri, 24 Oct 2014 in Ear, Nose and Throat Problems
Question: I am diagnosed as CSOM patient since 2013 of right year. Over the time, CSOM also affected my left year since two months. Today I underwent CT Scan of Mastoids. In right year all parameters external aud. canal, e.recess, middle ear cavity, Hypotympanum and atrum ossicular chain, facial never, cochlea, vestibule & semicular canals ... are entirely appear normal in left and right years as well. In both years sclerosis of mastoid antra noted. No cholesteatoma. No conventional medication since one year.
1. Kindly explain sclerosis of mastoid antra, the treatment if any possible, possible risk factors (risk in the sense death or physical disability other than hearing loss, such as brain infection factors in the next 12 months to come before I take up antoher CT review in next oct. 2015.
doctor
Answered by Dr. Sumit Bhatti 8 hours later
Brief Answer:
As below:

Detailed Answer:
Hi,

Thank you for your query.

1. Mastoid sclerosis is commonly seen in long standing CSOM. The normal pneumatization of the mastoid bone does not take place due to poor aeration and repeated infections of the middle ear. So instead of many air cells, there is dense bone.

2. This dense, sclerotic mastoid bone is inert and hence not a risk.

3. If there is no active CSOM in terms of symptoms and signs such as discharge, pain, perforations or cholesteatoma, there is no risk to life other than hearing loss.

4. Since your CT Scan is normal, there is no cause for worry. A regular follow-up every three months is fine.

5. The next time you decide to scan the ears, request an HR(High Resolution) CT Scan of teh Temporal Bones and an MRI Scan for Cholesteatoma. Thiss is a relatively new protocol and if these two scans are normal, there is absolutely no case for worry.

Hope I have answered your query. If you have any follow up queries, I will be available to answer them.

Regards.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Sumit Bhatti 6 hours later
Dr. XXXXXXX Bhatti,
Thank you for your advice.
The present condition is, as mentioned before, is CSOM with symptoms of nocturnal discharge, without pain. Hearing loss was diagnoised as 50% in right year and 20% in left ear. Day time no discharge usually. Night times, I wake up once or twice. Clean ears and white discharge with foul smell is cleaned. The quantity is very small. Some times, there is reddish tinge over the cotton.
There are no other symptoms such as pain. Cholesteatoma was not discovered in CT scan so no worry presently. However besides I talk to my ENT physician, this being only only general information, reassess my condition as seen from the above and this type of discharge is harmful to life. I was visiting ENT physician every month initially till nov. 2013 and it is explained that no antibiotics cures this condition. As there is no cure in modern medicine, trying HOMEOPATHY BUT NO RESULT TILL NOW. I also visit my doctor in a day or two. Please study well as a singular situation and forward the general information.
regards
vijaymohan XXXXXXX
doctor
Answered by Dr. Sumit Bhatti 3 hours later
Brief Answer:
As below:

Detailed Answer:
Hi,

Thank you for writing back.

1. There are different types of CSOM. I need to know if an ear drum perforation has been ruled out. Oto-endosocpic images of the ear drums will help to accurately assess the condition.

2. An image of your audiogram will help determine the type of hearing loss, conductive, sensorineural or mixed.

3. Scanty, foul smelling ear discharge suggests a cholesteatoma. Reddish tinge may be due to ear wax. If the reddish tinge is due to blood, it means that there is a granulation tissue (infection has spread to the bone/osteitis).

4. If you upload images of your CT scan, I can review them. Problem is that a CT scan alone cannot be used to diagnose a cholesteatoma. A late (45min) post contrast diffusion MRI Scan is required.

5. As far as cholesteatoma is concerned, it is true that the treatment is regular cleaning and surgical. Antibiotics, medication including homeopathy cannot cure a choelsteatoma.

6. If there is no cholesteatoma, or if there is an inactive retraction pocket, the risk of serious side effects is very low.

7. Kindly upload the above mentioned images and clinical findings to take this discussion forward.

Hope I have answered your query. If you have any follow up queries, I will be available to answer them.

Regards.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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