This 83 year old male patient presented with an early childhood history of middle ear disease having a unilateral simple mastoidectomy performed on AS at the age of 5 years. Pure tone audiometry AS (11k) reveals a mild, sensorineural loss of hearing with no significant air-bone gap. Tympanometry AS shows a flattened (Type B) tracing with a minimal peak near ambient air pressure.

The video oto-macroscopic (VOM) image [inline below (24k)] shows the post-auricular mastoid bowl and scar not atypical of this surgical procedure. Video Oto-Endoscopy (VOE) shows an intact bony EAC with a dull, thickened tympanic membrane. A small monomeric scar, probable site of paracenteses, is located postero-superiorly on the TM.