This 7 year old girl was in a motor vehicle accident 1 week prior to audiologic evaluation.  She was frightened and intermittently crying throughout the evaluation, limiting the  amount of information that could be gathered.  Tympanometry was not attempted due to the injuries, for fear of causing the child further pain.

She has left facial paralysis secondary to that accident.  Left hearing loss is suspected.

The right SRT is 15 dB HL, the left is 45 by air conduction and 10 by bone conduction.

• What could cause left facial paralysis and left hearing loss? Are the results sufficient?  Was the prioritizing of the tests to obtain appropriate?

Case donated by Tricia Sheehan, AuD, University of Miami