The fourth ventricle is midline and the posterior fossa structures are unremarkable. There is no evidence for hemorrhage or infarction. Imaging of the temporal bones on the right reveals narrowing of the external canal to the level of the tmypanic membrane, where there is apparent bony narrowing. The tympanic membrane is not thickened but is abnormally horizontally oriented. The middle ear ossicles on the right, particularly the orientation of the head of the malleus to the body of the incus, are abnormal.