Case of September 2022

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Clinical History:

An 8-year-old boy was referred from Student Health Service for left hearing loss. His teacher complained him of poor hearing in school for a year. There was all along no otorrhea nor otalgia. On otoscopic examination, the tympanic membrane was intact and there was no evidence of effusion noted. Pure tone audiometry suggested left-sided hearing loss at 50dB with an air-bone gap. The working diagnosis was left-sided conductive hearing loss. High Resolution Computed Tomography of Temporal Bone was therefore arranged for further investigation. 

Axial and coronal images of the left temporal bone: