Acute left otitis externa - swimmer's ear
Painful left ear with conductive deafness and foul smelling discharge
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Normal ear (image 1 and 3) shows no soft tissue thickening in the external canal and normal tympanic membrane. The inflamed left ear (image 2 and 4) shows circumferential soft tissue swelling in the external canal and slight thickening of the tympanic membrane (arrow). No bone erosion.
Benign otitis externa is a condition of the external canal that occurs usually in summer due to chronic dampness and warm conditions with inadequate drainage of the canal (hence the name swimmer's ear). It is rarely imaged radiologically as diagnosis is obvious and treatment quite simple, i.e. ear toilet and topical antibiotics (drops).
The so-called malignant or necrotising otitis externa is an aggressive skull base osteomyelitis often due to Pseudomonas in diabetics or immunosuppressed patients.