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Clinical Problem Solving
January 2015

Middle Ear Mass With Facial Weakness

Author Affiliations
  • 1Division of Otology and Neurotology, Department of Otolaryngology, Medical University of South Carolina, Charleston
JAMA Otolaryngol Head Neck Surg. 2015;141(1):89-90. doi:10.1001/jamaoto.2014.2606

A woman in her 70s presented for evaluation of a 3-month history of intermittent left-sided facial weakness associated with otalgia and facial pain. The patient also noted occasional left-sided facial twitching and mild imbalance during this time frame. Physical examination revealed a red, pulsatile bulging mass emanating from the superior two-thirds of the tympanic membrane extruding into the ear canal. At the time of her presentation, no facial weakness, spasm, or synkinesis were noted. An audiogram showed a 30-dB left-sided conductive hearing loss with bilateral moderate sensorineural hearing loss.

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