A 34-YEAR-OLD white woman presented with a history of childhood epilepsy (last seizure at age 14 years) and chronic otitis media requiring right-sided tympanoplasty with mastoidectomy in October 1995. In April 1996, she presented with persistent left middle ear effusion and a mass in her left middle ear. After biopsy of the mass with a partial left mastoidectomy, persistent drainage of clear fluid from the ear, decreased hearing, and tinnitus developed. The patient denied having any symptoms of vertigo, nausea, vomiting, otalgia, headache, or aphasia, and no changes in mental status were noted. Physical examination of her left ear revealed superior retraction of the tympanic membrane, with clear fluid in the middle ear space. The findings of the rest of her physical examination, including cranial nerve assessment, were normal. Her computed tomographic (CT) scan is shown in Figure 1 and Figure 2.
Gottlieb MBC, Blaugrund JE, Niparko JK. Imaging Quiz Case 1. Arch Otolaryngol Head Neck Surg. 1998;124(11):1274-1277. doi:10-1001/pubs.Arch Otolaryngol. Head Neck Surg.-ISSN-0886-4470-124-11-ori7399