A 73-year-old man presented for an updated hearing evaluation along with complaints of a white, flaky discharge from his left ear. He reported a long-standing history of hearing loss. He had been unable to wear a hearing aid on the left side for the previous 2 to 3 years because of chronic irritation. Physical examination of his left ear revealed scant otorrhea and a cystic structure in the posterior canal. An audiogram showed asymmetrical sensorineural hearing loss that was worse in his left ear but had been stable since his previous testing 7 years earlier. He was given ciprofloxacin-dexamethasone (Ciprodex) otic drops for his otitis externa. Magnetic resonance imaging of the brain was performed to evaluate the hearing loss and the posterior canal lesion. The results demonstrated no masses or asymmetry in the cerebellopontine angle cisterns. A 5 × 13 × 7-mm, lobulated, T2 hyperintense lesion was seen within the bony and cartilaginous portions of the left external auditory canal (Figure 1, arrow).
Jana T, Segel JM, Liles G, Weinberger PM, McKinnon BJ. Pathology Quiz Case 2. Arch Otolaryngol Head Neck Surg. 2012;138(8):779. doi:10.1001/archoto.2012.1307
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