The accompanying photograph shows the right ear of a patient who sustained a basilar skull fracture and fracture of the temporal bone many years before. The ear has been dry and free of any complaint with the exception of a 50-dB conductive hearing loss. There is minimal evidence of temporal bone fracture at the superior part of the annular ring along the notch of Rivinus. There is a healed postero-inferior perforation of the pars tensa, which has an opaque scar. The long handle of the malleus is in the normal position. The incus is in a normal position. The stapes can be seen through the translucent pars tensa. Treatment involves tympanoplasty performed through the external auditory canal on an elective basis.
From Gap, France (Dr. Deguine), and the Pulec Ear Clinic, Los Angeles (Dr. Pulec).
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