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TEMPORAL BONE QUIZ CASE
CHARLES W. GROSS, MD, BOSTON
At the age of 74 this patient was seen for purulent discharge, of several weeks' duration, coming through a large epitympanic perforation in his right ear. A large dry epitympanic perforation was also noted in the left ear. The discharge subsided with antibiotic therapy, and a subsequent audiogram revealed a bilateral combined sensorineural and conductive loss (Fig 1). Roentgenograms indicated bilateral sclerotic mastoids without evidence of destruction.
Three years later at the age of 77 he was admitted to the hospital with severe obstructive jaundice and found to have carcinoma of the pancreas. He died three weeks after an unsuccessful palliative operation. In the intervening three years he had had no further otorrhea but had been discovered to have diabetes and advanced atherosclerosis. This led to several operative procedures for peripheral vascular insufficiency and had precipitated a left middle cerebral artery
SATALOFF J. The Resident's Page. Arch Otolaryngol. 1966;83(5):494–497. doi:10.1001/archotol.1966.00760020496019
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