case_images: PMC8081636_01
case_images: Type As and type B tympanograms in the right and left ear, respectively, upon admission.
case_images: CRIOT2021-6632344.001.jpg
case_images: PMC8081636_01_CRIOT2021-6632344.001.jpg
case_images: fig1
case_images: 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).
case_images: Audiogram at presentation showing profound bilateral hearing loss.
case_images: CRIOT2021-6632344.002.jpg
case_images: PMC8081636_01_CRIOT2021-6632344.002.jpg
case_images: fig2
case_images: Pure tone audiogram revealed severe to profound right sensorineural hearing loss and profound left, possibly mixed hearing loss (Figure 2).
case_images: Sequential axial CT layers showing sclerotic mastoid air cells and aerated middle ears bilaterally with no evidence of effusion.
case_images: CRIOT2021-6632344.003.jpg
case_images: PMC8081636_01_CRIOT2021-6632344.003.jpg
case_images: fig3
case_images: The mastoid processes were sclerotic and hypopneumatized (Figure 3).
case_images: Coronal T1 spin echo showing abnormal bilateral postcontrast enhancement within the vestibule and semicircular canals.
case_images: CRIOT2021-6632344.004.jpg
case_images: PMC8081636_01_CRIOT2021-6632344.004.jpg
case_images: fig4
case_images: 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.
case_images: PA chest radiograph showing confluent opacity in the right lower lung.
case_images: CRIOT2021-6632344.005.jpg
case_images: PMC8081636_01_CRIOT2021-6632344.005.jpg
case_images: fig5
case_images: 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.