External and middle ear diseases: radiological diagnosis based on clinical signs and symptoms

OBJECTIVE: Pathology of the external and middle ear is the most frequent reason to prescribe antibiotics and perform surgery in children and young adults. In the majority of cases imaging studies are not performed; the need for imaging comes when complications are suspected or when treatment is not effective. This paper discusses indications for temporal bone imaging studies and presents the most frequent pathological conditions, together with differential diagnosis, clinical symptoms and methods of treatment. METHODS AND RESULTS: This pictorial review describes major external and middle ear diseases, with special regard to clinical findings and appropriate reporting. CONCLUSIONS: Apprehension of the complete clinical picture, together with imaging clues, narrows differential diagnosis and helps avoid mistakes. Evaluation of temporal bone pathologies requires close cooperation between the clinician and radiologist.