Hemotympanum

A 55-year-old female presents to the emergency department (ED) with a bloody nose (epistaxis). Her medical history is significant for chronic liver disease and past admissions requiring transfusions of platelets. She states she suffers from “daily” nose bleeds. This episode started earlier in the day and she has been using nasal packing and pressure to control it. While in the ED she states her hearing is muffled on the left side and requests a hearing test. She has no ear pain, fevers, or other infectious symptoms. She is jaundiced and ill-appearing on exam. Her HEENT assessment is notable for dried blood in the bilateral nares without active bleeding. Her WiscMed Wispr otoscope exam is shown.