A 43-year-old man presented with complaints of severe left otalgia, left otorrhea, and bilateral hearing loss. The patient had previously failed medical treatment for otitis media and had undergone a left mastoidectomy at an outside facility. Postoperatively, he developed a delayed facial palsy and recurrent symptoms. One month prior to his mastoidectomy, the patient underwent endoscopic sinus surgery, excision of a nasal mass, and left tympanostomy tube placement. A review of systems revealed bilateral knee pain, and he reported a family history of rheumatoid arthritis. His history was otherwise unremarkable.
Hobson CE, Chiosea S, Mohan N, McCall AA. Pathology Quiz Case 3. JAMA Otolaryngol Head Neck Surg. 2013;139(5):533. doi:10.1001/jamaoto.2013.2871a