R. NICKBRYANMDS. JAMESZINREICHMD
A 43-YEAR-OLD woman presented with a 2-week history of left-sided retro-orbital headache, diplopia, and hearing loss in her left ear after an upper respiratory tract infection. On examination, she was found to have purulent debris filling the left external auditory canal. Also, paralysis of the left abducens nerve, with diplopia on left lateral gaze, was noted. Audiometric study revealed a 40-dB conductive hearing loss in the left ear. Laboratory analysis revealed no evidence of leukocytosis, and the results of analysis of a cerebrospinal fluid specimen were normal.
Damrose EJ, Petrus LV, Ishiyama A. Quiz Case 2. Arch Otolaryngol Head Neck Surg. 2001;127(6):715. doi: