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April 1997


Arch Otolaryngol Head Neck Surg. 1997;123(4):442-445. doi:10.1001/archotol.1997.01900040088014

Pathologic Quiz Case 1  J. A. Lavy, FRCS; P. J. Wormald, FCS(SA), FRCS(Edin)A 44-year-old woman presented with an 18-year history of painless discharge from her right ear. The condition had been diagnosed elsewhere as simple otitis externa. Over the years, the patient had been seen by her own general practitioner on numerous occasions and had been referred to the local ear, nose, and throat department at least twice a year. She had been treated with oral and topical antibiotics, steroid creams, and self-administered over-the-counter medications. Her symptoms waxed and waned but never fully resolved. She did not have diabetes and had no history of trauma to her ear.Examination of the ear revealed a 5-mm-diameter ulcer in the floor of the canal, with exposed necrotic bone at the base of the ulcer (Figure 1 and Figure 2). The tympanic membrane was intact, and the findings of the rest