Para-aural mineralization found in 0.8% of canine head CTs, associated with tympanic bulla disease

Mineralization of the para-aural soft-tissue region between the tympanic bulla, hyoid apparatus and nasopharynx in dogs has not been described in veterinary literature. The objective of the study was to determine the prevalence of para-aural mineralization on head computed tomography (CT), describe its morphological features, and assess associations with middle-ear disease, body weight, age, and breed. This retrospective case–control study of 1,833 canine head CTs (January 2012 – December 2024) identified para-aural mineralization in 15 dogs (0.8%) and affected cases were compared with 30 breed-matched controls. Affected dogs were predominantly male, median age 9.4 years and weight 27.3 kg, with lesions frequently bilateral, ventrolateral to the tympanic bulla, and having a median area 12.4 mm2 (median Hounsfield Units 424). All affected cases also showed external ear canal wall mineralization and 87% cf. 43% in the control cases had concurrent tympanic bulla disease (wsall thickening, lysis, and luminal soft tissue/fluid, or hyperostotic tympanic bone spicules) (p = 0.009), whereas age (p = 0.065) and weight (p = 0.709) did not differ significantly between the two groups. Dogs with para-aural mineral formations were more likely to have other soft tissue mineralization noted in the head CT. Cases with serial scans revealed coalescence of fragments, suggesting a dynamic calcification process. These CT findings indicate that para-aural mineralization is uncommon, but imaging findings could serve as a marker of occult chronic middle ear disease, rather than being associated with age or body weight.