We performed a retrospective chart review to categorize a group of petrous apex findings that were noted incidentally on magnetic resonance imaging (MRI) in 88 patients. These patients were among those who had been seen at a tertiary care center between July 1988 and July 1998. These incidental findings, which were unrelated to the presenting clinical manifestations, included asymmetric fatty bone marrow (n = 41), inflammation (19), cholesterol granulomas (14), cholesteatomas (9), and neoplasms (5). Followup imaging and clinical surveillance of these patients has not demonstrated any significant change in the incidentally detected lesions. In all cases, the incidental MRI findings represented benign pathology.
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