case_images: PMC9890240_01
case_images: Axial cut in the inferior aspect of the external auditory canal in patient A (CT of the temporal bone) demonstrating the indentation of the inferior aspect of the external auditory canal.
case_images: rjad016f1.jpg
case_images: PMC9890240_01_rjad016f1.jpg
case_images: f1
case_images: On initial evaluation, the unusual clinical presentation triggered a workup with a CT of the temporal bone (Fig. 1), revealing a minor area of cortical erosion in the inferior wall of her right bony external auditory canal.
case_images: Right external auditory canal on patient A demonstrating excellent mucosalization of the indentation in the inferior aspect of the external auditory canal after serial cerumen debridement procedures in the office.
case_images: rjad016f2.jpg
case_images: PMC9890240_01_rjad016f2.jpg
case_images: f2
case_images: Photographic documentation in her most recent visit (10/2022) revealed healthy appearing healthy mucosalization of the cavity and minimal amount of ceruminous debris (Fig. 2).
case_images: Panel a shows the indentation of the left external auditory canal with bony sequestration. Picture was after debridement. Panel b shows the right external auditory canal. Less extensive than the left, however, fragmentation and sequestration is also seen.
case_images: rjad016f3.jpg
case_images: PMC9890240_01_rjad016f3.jpg
case_images: f3
case_images: Albeit minor, there was obvious bony sequestration in the area of the lesion and miniscule osseous fragments were retrieved from the indentation with a microsuction (Fig. 3a). Interestingly, the patient was noticed to have a similar but smaller lesion (erosive indentation in the inferior wall of his external auditory canal) on the contralateral side, which was managed on the same manner with serial debridements (Fig. 3b).