Head and Neck Q9

A Chinese investment banker in his 40s presents with right-sided unilateral mild hearing loss associated with tinnitus over the last 2 months. He denies otalgia or otorrhoea. He reports occasional episodes of mild epistaxis over the past month, which he puts down to ‘working hard and partying hard’. Otherwise he is feeling completely well in himself. When asked about his past medical history, he recalls having ‘bad tonsillitis’ requiring overnight hospital admission at the paediatric ward when he was 16 years old. Otoscopy reveals a glue ear on the right side.

Which of the following is the next best investigation?

  • A) MRI head
  • B) Flexible nasoendoscopy
  • C) Arrange for an elective grommet insertion
  • D) CT head
  • E) Ultrasound of the neck