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Clinical Problem Solving: Radiology |

Radiology Quiz Case 1

Madhankumar Krishnan, DO-HNS, MRCS; Natasha Choudhury, DO-HNS, MRCS; Gaurav Kumar, DO-HNS, MRCS; Gavin W. Watters, FRCS
Arch Otolaryngol Head Neck Surg. 2008;134(2):210. doi:10.1001/archoto.2007.31-a.
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A 50-year-old woman presented with an 8-month history of unilateral left-sided otalgia and tinnitus. The findings of her ear, nose, and throat examination were remarkable only for a House-Brackmann grade II lower motor neuron facial palsy on the left side. Her audiogram confirmed normal hearing in both ears. Magnetic resonance imaging of the internal auditory meatus was performed to investigate her unilateral tinnitus. The findings were reported to be normal, but it was later found that a subtle soft tissue signal was present in the left mastoid complex instead of the absence of signal that would be expected. The facial palsy was treated with prednisolone (initally at 60 mg/d, with gradual reduction of dosage thereafter). The patient made a complete recovery and was subsequently discharged.

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