Figure 1: (Case A) Axial T1-weighted MR image with fat suppression after administration of Gadolinium at the level of the petrous bones (a) and just below the skull base (b). Indicated in a are the bilateral inflammatory changes in the petrous apices (short open arrows), bilateral involvement of the basal turn of the cochlea (long open arrows), extensive bilateral pachymeningeal involvement at the temporal lobes (short closed arrows), opacification of both mastoids and middle ears (medium closed arrows), and the mass in the left middle nasal passage extending up to the left Eustachian tube as visualized during fiber endoscopy (long closed arrow). Extension of the abscess into the parapharyngeal space, resulting in a bulge of the contour of the nasopharynx, is also shown (b, medium closed arrow).