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Clinical Problem Solving: Pathology
Sep 2012

Pathology Quiz Case 1

Author Affiliations
 

SECTION EDITOR: EDWARD B. STELOW, MD

Arch Otolaryngol Head Neck Surg. 2012;138(9):871. doi:10.1001/archoto.2012.1668

A 61-year-old man presented with a 13-year history of slowly progressing left-sided facial weakness, numbness and pain, otitis media, and postnasal drainage. At presentation, the cause remained undiagnosed. Physical examination revealed left-sided facial swelling, with displacement of the zygoma laterally. The anterior wall of the left external auditory canal (EAC) was bowed posteriorly, with mucopurulent otorrhea. There were incomplete left eye closure; complete numbness in the distribution of left mandibular nerve, with asymmetry of the ophthalmic and maxillary nerve areas; and twitching in the distribution of the left facial nerve. Fiberoptic laryngoscopy revealed mucoid postnasal drainage.

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