case_images: PMC11750634_01
case_images: A
  - left EAC polyp.
case_images: ijo-37-1-55-g001.jpg
case_images: PMC11750634_01_ijo-37-1-55-g001.jpg
case_images: F1
case_images: Otoscopic examination revealed the Left EAC polyp obstructing the view to any deeper structures (Fig 1A). On the left side, total mastoid and middle ear opacification, facial nerve dehiscence, ossicular erosion, tympanic membrane effacement and mastoid bone erosion were observed (Figure 1B). Magnetic resonance imaging (MRI) revealed a left-loculated mastoid lesion with total opacification of the mastoid and middle ear cavities (Figure 1C).
case_images: B
  - HRCT petrous bone, bone window, axial view showing bilateral total opacification of the middle ear cleft and mastoid on the right side. On the left side, additional ossicular erosion, tympanic membrane effacement and mastoid bone erosion were observed.
case_images: ijo-37-1-55-g002.jpg
case_images: PMC11750634_01_ijo-37-1-55-g002.jpg
case_images: F2
case_images: The polypoidal tissue was seen invading most of the skin of the external auditory canal (EAC) and the whole tympano-meatal flap (TMF) (Figure 2A). The polyps were sent for histopathological examination after maximum debulking (Figure 2B).
case_images: C
  - MRI coronal T1 post contrast showing left loculated mastoid lesion with rim enhancement and total opacification of both the mastoid and middle ear cavities.
case_images: ijo-37-1-55-g003.jpg
case_images: PMC11750634_01_ijo-37-1-55-g003.jpg
case_images: F3
case_images: Gram-negative bacilli were also detected in the Mikulicz cells (Figure 3 A, B, C).