29) The operational definitions for postural assessment used in this study were as follows: a subject was identified as having a forward head if the subject's external auditory meatus was anteriorly deviated (anterior to the lumbar spine), (29) and the shoulders were identified as protracted if the acromion was noted to be anteriorly deviated (anterior to the lumbar spine).

Examination revealed a firm, nontender lesion behind the left pinna and a large lesion in the conchal bowl that completely occluded the external auditory meatus (figure 1, A).

The first branchial cleft becomes the external auditory meatus, and the first branchial pouch gives rise to the middle ear and eustachian tube.