Findings: Photograph when crying (figure 1)
1. Asymmetric face
2. Difficult closing of left eye
3. Paralysis of left side of the mouth.
4. From above findings, left side peripheral facial palsy is considered.
Photograph (3 m/o) (figure 2)
1. Similar finding as figure 1
Otoacoustic emissions (OAE) (figure 3)
1. Downward displacement of left ear results (red arrows) below
normal lower limit (normal range between blue arrows), suggesting
abnormal function of outer hair cells in left cochlear.
2. Normal right ear results (green arrows) between normal range.
Auditory brainstem response (ABR) (figure 4)
1. Poor morphology of left side with loss normal V wave in left side,
suggesting sensorineural hearing impairment.
2. Normal right side for comparison. Normal V waves (arrows).
Low dose multidetector row CT scan of temporal bone with
multiplanar reconstruction, and without intravenous contrast
(figure 5 and 6):
1. Increased opacity in left middle ear cavity and left mastoid air
cells, may due to otitis media and mastoiditis.
Less possibility: middle ear soft tissue mass.
2. Very small caliber of the orifice of left internal auditory
canal in vertical diameter (arrow in figure 6), suggesting
congenital hypoplastic internal auditory canal and possibly
associated sensorineural hearing impairment, peripheral facial
nerve palsy, or dizziness and tinnitus.