case_images: PMC10762567_01
case_images: HRCT temporal in (A) axial soft tissue window, (B) axial bone window, and (C) coronal bone window. Presence of fluid density within the external and middle ear cavities (long arrow) as well as mastoid air cells (arrowhead) indicating left otitis externa, left otitis media, and left mastoiditis. The normal left tympanic membrane is not visualized. There is a dehiscence of the left tegmen tympani (curved arrow) seen in image (C), suggestive of bony erosion.. HRCT: high-resolution computed tomography
case_images: cureus-0016-00000051560-i01.jpg
case_images: PMC10762567_01_cureus-0016-00000051560-i01.jpg
case_images: FIG1
case_images: Figure 1 shows the initial high-resolution computed tomography (HRCT).
case_images: HRCT temporal in (A) axial and (B) coronal views taken about one month apart, demonstrating erosion of the middle ear cavity (long arrow) and worsening dehiscence of the left tegmen tympani. HRCT: high-resolution computed tomography
case_images: cureus-0016-00000051560-i02.jpg
case_images: PMC10762567_01_cureus-0016-00000051560-i02.jpg
case_images: FIG2
case_images: HRCT temporal bone was repeated (Figure 2 and Figure 3), which revealed a constellation of CT features that were suggestive of base of the skull osteomyelitis with post-surgical changes of the left mastoid bone.
case_images: HRCT temporal (A) in soft tissue and (B) in bone windows shows a fullness of the left fossa of Rosenmuller (arrowhead) with associated erosion of the left base of the skull. HRCT: high-resolution computed tomography
case_images: cureus-0016-00000051560-i03.jpg
case_images: PMC10762567_01_cureus-0016-00000051560-i03.jpg
case_images: FIG3
case_images: HRCT temporal bone was repeated (Figure 2 and Figure 3), which revealed a constellation of CT features that were suggestive of base of the skull osteomyelitis with post-surgical changes of the left mastoid bone.
case_images: HRCT of temporal (A) in sagittal and (B) coronal views three months later show persistent fullness in the posterior nasopharynx with clival erosion (long arrow). There are also worsening bony erosions at the left base of the skull (arrowhead).. HRCT: high-resolution computed tomography
case_images: cureus-0016-00000051560-i04.jpg
case_images: PMC10762567_01_cureus-0016-00000051560-i04.jpg
case_images: FIG4
case_images: HRCT temporal bone (Figure 4) showed left foramen of Rossenmuller obliteration, no fat plane separating the left para-pharyngeal and prevertebral plane space, the clivus was eroded, and the jugular foramen widened.