Figure 2. Case 2 – Imaging of the petrous bone in a patient with left malignant otitis externa: axial and multi-planar reformations of unenhanced CT scan with bone reconstruction algorithm (A–C) showed secondary opacification of the left mastoid air cells compared to the normally aerated right side (A: black arrowhead), stenosing soft tissue thickening of the external auditory canal (B: white arrowhead) with focal bony erosion of the inferior wall and extensive erosive phenomena of the temporal bone as well as the adjacent clivus (C: white arrow). Contrast-enhanced CT scan with soft tissue reconstruction algorithm of the petrous bone (D, E) showed asymmetrical swelling of the oropharynx with areas of diffuse contrast uptake extending to retropharyngeal, para-pharyngeal and carotid space on the left side. Carotid space vessels were displaced (E: white circle); lumen reduction due to external compression without thrombosis of the internal jugular vein was present, with normal opacification of the transverse and sigmoid sinus above (E: black arrow).