PMC8081636_01
Type As and type B tympanograms in the right and left ear, respectively, upon admission.
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Otomicroscopy revealed intact tympanic membranes with no apparent middle ear effusions; however, impedance audiometry suggested possible middle ear pathology with a right type A tympanogram and left type B (Figure 1).
Audiogram at presentation showing profound bilateral hearing loss.
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Pure tone audiogram revealed severe to profound right sensorineural hearing loss and profound left, possibly mixed hearing loss (Figure 2).
Sequential axial CT layers showing sclerotic mastoid air cells and aerated middle ears bilaterally with no evidence of effusion.
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The mastoid processes were sclerotic and hypopneumatized (Figure 3).
Coronal T1 spin echo showing abnormal bilateral postcontrast enhancement within the vestibule and semicircular canals.
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T1 spin echo with gadolinium contrast (Figure 4) revealed increased signal intensity within labyrinths bilaterally suggesting an inflammatory process and breakdown of the blood-labyrinth barrier within the inner ear.
PA chest radiograph showing confluent opacity in the right lower lung.
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Chest X-ray showed a right lower lobe opacity (Figure 5), which was unchanged from an X-ray conducted several months prior, suggesting a chronic pulmonary process.