This is a report of an unusual case of a patient with secretory otitis media, a conductive hypacusis, retro-orbital pain, and diplopia.A 42 year old Air Force master sergeant was admitted to the USAF Hospital, Travis, on September 4, 1962 for further evaluation of diplopia and left-sided facial pain. About one year prior to admis sion he noticed a gradual onset of decreased hearing in the left ear. This progressed slightly and was accompanied by occasional tinnitus. About two weeks prior to admission he had a sudden onset of diplopia associated with severe left retro-orbital and temporoparietal pain. The pain was also referred into the left neck and was associated with a numb feeling in the left temporal area. After approximately one week there was a definite improvement in all of the symptoms.The past history revealed no major illnesses. He had an appendec tomy in childhood. He denied any past history of otitis media either in childhood or later in life.The physical examination on admission to the neurosurgical service revealed the left pupil to be slightly smaller than the right with reduction in the left palpebral fissure. No nystagmus was observed but the left eye deviated slightly laterally. There was no facial nerve impairment. Touch and pain sensation over the left

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