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CT scan can be used to show the anatomical and pathological evaluation of Mastoid bones using X-ray to create a cross-sectional images with an advanced computer. This imaging modality allows the radiologist to look at different levels of the bone ridge behind the ear. In our hospital, this procedure needs to be improved. Radiographer could make optimization by adjusting windows and developing kernel to maintain the image quality. This study aimed to obtain the optimum image of Mastoid bones, using variations of window and kernel reconstruction. The study was descriptive quantitative with an experimental approach. It resulted in eight images of two windowing levels (sinus and inner ear) and four kernel variations (smooth, medium, sharp, and ultra-sharp). Three radiologists evaluated the injury, bleeding and soft tissue abnormalities images. The result showed that all window settings are acceptable. Kernel reconstructions have no different anatomical image information in soft tissue, Internal Auditory Canal and External Auditory Canal. There is a difference for overall anatomical information of Mastoid bones (p value<0.05). Highest values of mean rank are obtained from sharp and ultra-sharp. Our recommendations are using the H.20s smooth kernel for soft tissue abnormalities and H.70s sharp kernel for fracture and bleeding cases.