External auditory canal osteoma

Case contributed by Mostafa Elfeky
Diagnosis almost certain

Presentation

Left side conductive hearing loss

Patient Data

Age: 45 years
Gender: Female

A well corticated osseous body is seen at the outermost part of the left external auditory canal attached to its roof with a bone pedicle (best seen on coronal). It is almost obstructing the canal with surrounding soft tissue thickening.

Normal CT features of the left middle ear, rest of external auditory canal and inner ear.

Case Discussion

Features are consistent with pedunculated external auditory canal osteoma with surrounding soft tissue thickening suggestive of associated otitis externa.

Differential diagnosis is external auditory canal exostosis (surfer's ears), which are broad-based bone elevations, usually multiple and bilaterally symmetric, involving the bony walls of the external auditory canals.

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