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Clinical Problem Solving: Radiology
October 2005

Radiology Quiz Case 1

Author Affiliations
 

R. NICKBRYANMDPATRICIA A.HUDGINSMD

Arch Otolaryngol Head Neck Surg. 2005;131(10):921. doi:10.1001/archotol.131.10.921

A 15-year-old girl presented with a long history of runny nose and nasal obstruction. She also had a near-total hearing loss in the left ear and a moderate mixed hearing loss in the right ear. Other findings included a triangle-shaped right ear, coloboma, physical and developmental delay, absence of the ovaries, and epilepsy.

Axial computed tomography of the temporal bones (Figure 1) demonstrated bilateral absence of the semicircular canals. Figure 2 and Figure 3 show coronal computed tomographic scans of the left temporal bone in the present case (Figure 2) and in a case with no abnormalities (Figure 3). The black arrows in Figure 3 point to the normal superior and lateral semicircular canals. The arrowheads in Figures 2 and 3 indicate the position of the oval window. Our patient had atresia of the left oval window, demonstrated with a bony cover at this site (Figure 2). The white arrows in both figures indicate the facial nerve, which is more medially located in our patient (Figure 2) than in the patient with the normal temporal bone (Figure 3).

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