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Clinical Problem Solving: Radiology
April 18, 2011

Radiology Quiz Case 2

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Copyright 2011 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Restrictions Apply to Government Use.2011

Arch Otolaryngol Head Neck Surg. 2011;137(4):405. doi:10.1001/archoto.2011.41-a

A 58-year-old woman presented with a history of bilateral sensorineural hearing loss at high frequencies, with a middle- and low-frequency conductive loss, intact acoustic reflexes, and tinnitus since childhood, that had progressed in the last 2 years. She complained of 2 episodes of short-duration vertigo related to noise exposure in the last 6 months. The tinnitus did not change during the vertigo episodes. Her mother had presbycusis, and a first cousin had undergone a stapedectomy without recovery of hearing. A computed tomographic scan of the left temporal bone was performed, and an axial slice is shown in Figure 1. The patient also underwent magnetic resonance imaging (Figure 2) and assessment of vestibular evoked myogenic potentials, which showed an abnormally low response.

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