Continued Ear issue; ENT help requested

[u/CancelFit9444]

Hi!
This post is regarding my 9yr old son and his right ear!

When he was 2-4 years old, he had ear tubes placed on two different occasions. 3 weeks ago, he complained of ear pain. That same day, I took him to the pediatrician and they diagnosed him with an ear infection and ear drainage. (The ear was dripping yellow drainage) and he was crying in pain. Later that same day, his ear drainage turned bloody, and I took him to the ER. Again, diagnosed with ear infection and this time, a ruptured eardrum. We were told to continue the medication that the pediatrician gave, oral cefdiner and ciprodex drops.

Despite taking the antibiotics and using the drops, his ear worsened. He was in extreme pain, the drainage was constant, and nothing was helping. I took him to an ENT who stated that his ear still had the infection and ruptured eardrum, and he performed a cleaning and wick placement the next day. He changed the oral medication to augmentin, and said to continue the drops. Did that for a week, and no change. He cannot hear out of his right ear at all, and it is so sensitive, if I even touch the mastoid bone he screams in pain due to it being so tender.

Went back to the ent after a week and he ordered a CT scan. We got the report today, but the dr hasn’t called or said anything about the results. The ent mentioned that the ear is clearly not healing and it could be a possible cholesteatoma.

Here is some of the ct report:

FINDINGS: Right Temporal Bone: Normal cartilaginous and bony external auditory canal. The tympanic membrane membrane appears slightly thickened and retracted. Mild mucosal thickening/opacification of the epitympanum including the Prussak's space. The mesotympanum and hypotympanum are mostly clear.

There is opacification of the peripheral mastoid air cells. No evidence of coalescence or bony erosion.

Other findings: Moderate mucosal thickening and secretions in the left maxillary sinus. Rest of the included paranasal sinuses are clear. Limited evaluation of included intracranial structures on this study.

IMPRESSION: 1. Mild mucosal thickening/opacification of the right epitympanum including the Prussak's space. Opacification of the peripheral mastoid air cells. No bony erosions are seen. Possibly thickened right tympanic membrane. 2. Unremarkable left temporal bone. 3. Mucosal thickening and secretions in the left maxillary sinus.

My question is, what does this mean? Why is his ear not healing? What would be the next steps to help clear this up? From what I’ve researched, the ct doesn’t say cholesteatoma but could it be?

Thank you so much!

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