Born With It?

Question: A 3 year old boy is seen in the clinic for an abnormality discovered on otoscopy. The primary care notes indicate that the appearance of the anterior superior quadrant of the right tympanic membrane was “dull”. He has no hearing loss on conditioned play audiometry. Physical exam demonstrates a whitish area on the medial surface of the tympanic membrane anterior to the handle of the malleus. There is no middle ear effusion, myringosclerosis, or other abnormality. What is the most likely diagnosis?

[Answer will be posted with next week's new question]

Answer to last week's question, "Collateral Damage" (November 5, 2018)

Vidian nerve.