Skip to main content

Incidental mastoiditis on magnetic resonance imaging scans: clinical relevance and cost implications

  • Y Abbas (a1), H S Yuen (a1), A Trinidade (a1) and G Watters (a1)

To determine: (1) the incidence of incidental ‘mastoiditis’ reported on magnetic resonance imaging scans performed in patients with asymmetrical sensorineural hearing loss and/or unilateral tinnitus; (2) how many of those patients have actual otological pathology and/or require treatment; and (3) the financial implications of such a reporting practice.


Retrospective case series.


Between October 2015 and November 2016, 500 patients underwent magnetic resonance imaging of the internal auditory meatus to rule out cerebellopontine angle lesions. There was an incidental finding of increased mastoid signalling in 5.8 per cent (n = 29), of which 20.7 per cent (6 of 29) were reported as bilateral cases. The diagnosis of ‘mastoiditis’ was found in 39.7 per cent (29 of 73). None of these patients had any pathology identified clinically. Other significant pathology was identified in a further 8.8 per cent (n = 44).


The diagnosis of mastoiditis is primarily clinical. An incidental finding of high signalling in the mastoid region on magnetic resonance imaging is highly unlikely to represent actual clinical disease. In patients who are scanned for other reasons and who do not complain of otological symptoms, such findings are unlikely to require otolaryngology input.

Corresponding author
Author for correspondence: Mr Aaron Trinidade, Otolaryngology Department, Southend University Hospital NHS Foundation Trust, Prittlewell Chase, Westcliff-on-Sea SS0 0RY, UK E-mail: Fax: +44 (01)702 385 145
Hide All

Mr A Trinidade takes responsibility for the integrity of the content of the paper

Hide All
1Anderson, KJ. Mastoiditis. Pediatr Rev 2009;30:233–4
2Mafee, MF, Singleton, EL, Valvassori, GE, Espinosa, GA, Kumar, A, Aimi, K. Acute otomastoiditis and its complications: role of CT. Radiology 1985;155:391–7
3Meredith, JR, Boyev, KP. Mastoiditis on MRI: fact or artifact? Ear Nose Throat J 2008;87:514–19
4Minks, DP, Porte, M, Jenkins, N. Acute mastoiditis: the role of radiology. Clin Radiol 2013;68:397405
5Polat, S, Aksoy, E, Serin, GM, Yıldız, E, Tanyeri, H. Incidental diagnosis of mastoiditis on MRI. Eur Arch Otorhinolaryngol 2011;268:1135–8
6Pauker, SG, Kopelman, RI. Trapped by an incidental finding. NEJM 1992;326:40–3
7Singh, S, Rettiganti, MR, Qin, C, Kuruva, M, Hegde, SV. Incidental mastoid opacification in children on MRI. Pediatr Radiol 2016;46:704–8
8Von Kalle, T, Fabig-Moritz, C, Heumann, H, Winkler, P. Incidental findings in paranasal sinuses and mastoid cells: a cross-sectional magnetic resonance imaging (MRI) study in a pediatric radiology department. Rofo 2012;184:629–34
9Saat, R, Mahmood, G, Laulajainen-Hongisto, A, Lempinen, L, Aarnisalo, AA, Jero, J et al. Comparison of MR imaging findings in paediatric and adult patients with acute mastoiditis and incidental intramastoid bright signal on T2-weighted images. Eur Radiol 2016;26:2632–9
Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

The Journal of Laryngology & Otology
  • ISSN: 0022-2151
  • EISSN: 1748-5460
  • URL: /core/journals/journal-of-laryngology-and-otology
Please enter your name
Please enter a valid email address
Who would you like to send this to? *



Altmetric attention score

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed