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April 1969

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Arch Otolaryngol. 1969;89(4):674-677. doi:10.1001/archotol.1969.00770020676022

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PATHOLOGIC QUIZ CASE  A. Thomas Kuramata, MD, and Murray M. Hausner, MD, Covina, CalifFor about one month a 38-year-old white man complained of stuffiness and loss of hearing in his left ear.Physical examination showed the right ear to be normal. The left tympanic membrane, however, appeared dull, soggy, and pneumatic scope showed no movement with the Weber test lateralized to the left side. The audiogram showed an air conduction level of 55 db in the conversational range with normal bone conduction on the left side and normal hearing on the right. The left pupil was miotic (a left Horner's syndrome was present). The nose and paranasal sinuses were clear. The throat and posterior pharyngeal wall were covered with purulent discharge apparently originating in the nasopharynx. Due to a strong gag reflex, mirror examination of the nasopharynx was not possible. The left vocal cord was found to be stationary

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