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External auditory canal exostoses - surfer's ear

Case contributed by Fabien Ho
Diagnosis certain

Presentation

Symptoms of chronic right otitis media. Patient is a regular diver.

Patient Data

Age: 50 years
Gender: Male

Bilateral external auditory canal lesions consisting of cortical bone and periosteum, located deeply within the external auditory canal (not at the cartilage-bone junction), and causing circumferential stenosis. 

Case Discussion

The patient is a regular diver: both CT and clinical history are consistent with EAC exostosis.
There are signs of non-cholestatomatous chronic otitis media on the right.

Possible differential from otoscopy's point of view: EAC osteoma, which is usually unilateral, located at the bony-cartilaginous junction, and has a round shape.

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