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October 1974

The Resident's Page

Author Affiliations

The Methodist Hospital, Houston 77025

Arch Otolaryngol. 1974;100(4):324-326. doi:10.1001/archotol.1974.00780040334020


Thomas E. Smith, Jr., MD, and Robert E. Fechner, MD, Houston  A 51-year-old white man first noted a painless mass below the angle of his mandible in 1956. The mass slowly enlarged and in 1959 was excised locally. He had no further problem until 1966 when he noted onset of right-sided facial weakness associated with a recurrent mass at the site of excision. The facial weakness slowly progressed to paralysis, and in April 1972, he underwent total parotidectomy with resection of the facial nerve.In August 1972, a 2-cm recurrence was noted and excised locally. Thereafter, the patient experienced a progressive loss of hearing in the right ear. In June 1973, a biopsy specimen of a right middle ear mass was obtained (Fig 1 and 2). Mastoid x-ray films and temporal bone polytomography showed widening of the mastoid portion of the facial canal and medial displacement of

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