A man in his 70s with a history of a right middle ear lesion resected twice in the previous year at an outside institution was referred for a recurrent right ear mass. He initially presented with progressive bilateral hearing loss, more profound in the right ear, and denied otal-gia, otorrhea, tinnitus, vertigo, or feeling of fullness. He recalled a distant history of military noise exposure but no other clinically significant otologic history. The physical examination revealed an ery-thematous, bulging tympanic membrane without perforation.
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