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Clinical Problem Solving: Pathology
January 18, 2010

Pathology Quiz Case 2

Author Affiliations


Arch Otolaryngol Head Neck Surg. 2010;136(1):101. doi:10.1001/archoto.2009.181-a

A 36-year-old human immunodeficiency virus–positive woman presented with complaints of hearing loss in her right ear, otorrhea, and a mass in her external auditory canal (EAC). She had been noncompliant with antiretroviral therapy. Physical examination revealed extensive polypoid tissue in the EAC and right-sided facial paresis (House-Brackmann grade III/VI). Audiological evaluation showed a right maximal conductive hearing loss. Findings on computed tomography of the temporal bone were consistent with chronic otomastoiditis. The patient underwent a right canal wall down tympanomastoidectomy and facial nerve decompression. Pathologic evaluation of the specimen demonstrated fibroconnective tissue with chronic inflammation and focal necrosis.

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