Bilateral Otitis Media and Mastoiditis on Airway Evaluation

A 4-year-old female was referred for evaluation of airway concerns and a narrow palate. During full-volume review, the radiologist identified significant congestion within the middle ears and mastoid air cells, consistent with bilateral otitis media and mastoiditis. The findings prompted a referral to an ENT specialist, who subsequently placed tubes and removed copious amounts of fluid and suppuration. The patient's mother reported that the child's hearing had been significantly impaired, as though she were underwater, but because the child was not experiencing pain or discomfort, the condition would not have been identified without the CBCT review. Following treatment, the patient's hearing improved substantially. The radiologist noted that mastoiditis, if left untreated, can lead to serious complications, making early identification through full-volume review particularly valuable.