A 61-year-old white man presented with a 2-year history of bilateral hearing loss, aural fullness, and tinnitus. His history was remarkable for 1 episode of otitis externa, which had been treated successfully with ototopical antibiotics, 8 years before presentation. Since then, he intermittently irrigated his ears with an astringent solution (Domeboro) once a month for routine ear canal hygiene. He had no underlying dermatitis or family history of hearing loss or chronic otitis media, and he regularly used binaural hearing aids to treat a symmetrical, moderately severe sensorineural hearing loss. He denied any prior otologic trauma, surgery, or use of cotton-tip applicators.