Case Challenge An 18-year-old male presented with a six-month history of intermittent left-sided otalgia and reduced hearing. Initially, he experienced foul-smelling otorrhea, which later resolved; however, ear discomfort and hearing loss persisted.
Medical history No history of ear trauma or surgery Consulted multiple general practitioners over the past three months without improvement Otoscopic examination Impacted wax with keratin debris (Figure 1 A) Keratinized mass occupying the external bony canal Exposed bone with scant, foul-smelling mucopus Erosion of the posterior wall and floor (Figure 1 B) Intact tympanic membrane Right ear examination – Normal No facial nerve weakness Figure 1 : Oto-endoscopic view of the affected ear; Source: Cureus Pure tone audiometry Mild conductive hearing loss in the left ear Normal hearing in the right ear High-resolution computed tomography (HRCT;…
