Question: A 76 year old woman is transferred to the ED with concerns for malignant otitis externa. The right ear canal is edematous and therefore a view of the TM cannot be obtained. Cranial nerve status is normal. MRI demonstrates coalescence of the mastoid tip and inflammatory change throughout the mastoid and surrounding soft tissues. The cochlea appears normal. As well, the radiologist notes “narrowing of the sigmoid sinus”. The left sigmoid is diminuitive. Which of the following is the patient at significant risk of developing?

a) Otic hydrocephalus

b) Cholesteatoma

c) Labyrinthitis ossificans

d) Pulmonary embolism

[Answer will be posted with next week's new question]

Answer to last week's question, “The Bleeding Edge” (July 12, 2021)

B - MRI of the brain.