With the advent of multidetector computed tomography (MDCT), imaging of paranasal sinuses prior to functional endoscopic sinus surgery (FESS) has become mandatory. Multiplanar imaging, particularly coronal reformations, offers precise information regarding the anatomy of the sinuses and its variations, which is an essential requisite before surgery.

Internal hernias may present as intestinal obstruction and account for 0.5 to 4.1 % of all cases. Clinical diagnosis of internal hernias is often difficult and thus imaging studies plays an important role in the early diagnosis. It is vital for the radiologist to be familiar with the various types of internal hernias and their radiological features so that prompt diagnosis and early intervention can be made.

Combination of middle and inner ear anomaly is extremely rare. We describe a case where there was inner and middle ear anomaly on the right side and inner ear anomaly on the left side. This patient also had anomalous interposition of air cells between the middle and inner ear on the right side which precluded the use of cochlear implant. No such findings have been reported till date to the best of our knowledge.