case_images: PMC11010635_01
case_images: (A) Pure-tone audiometry (PTA) before the first surgery. (B) PTA after the second surgery.
case_images: fsurg-11-1353116-g001.jpg
case_images: PMC11010635_01_fsurg-11-1353116-g001.jpg
case_images: F1
case_images: The pure-tone audiometry (PTA) revealed deafness on the right side and a 30 dB air-bone gap indicating mixed hearing loss on the left side (Figure 1A). After the removal of ear tamponade on both sides, the hearing threshold in PTA improved (Figure 1B).
case_images: CT scan of temporal bones. Bilateral irregular calcified lesion with regular borders that cannot be distinguished from the eardrum and does not damage the ossicular chain.
case_images: fsurg-11-1353116-g002.jpg
case_images: PMC11010635_01_fsurg-11-1353116-g002.jpg
case_images: F2
case_images: Additionally, proper ventilation of the mastoid cell system was observed on both sides (Figure 2).
case_images: Intraoperative finding after removing the mass from the tympanic membrane.
case_images: fsurg-11-1353116-g003.jpg
case_images: PMC11010635_01_fsurg-11-1353116-g003.jpg
case_images: F3
case_images: Based on these findings, the patient underwent an initial right tympanoplasty to remove the calcified mass (Figure 3).
case_images: Two samples at both 25x (A,C) and 100x (B,D) magnifications: One using standard hematoxylin and eosin (HE) staining in normal light microscopy (A,B) and the other in polarization microscopy (C,D), where urate crystals exhibited a distinct brilliance.
case_images: fsurg-11-1353116-g004.jpg
case_images: PMC11010635_01_fsurg-11-1353116-g004.jpg
case_images: F4
case_images: These findings are primarily indicative of a gouty tophus, ruling out the possibility of pseudogout or chondrocalcinosis (Figure 4).