1. Presented by Peter Illei, M.D. and prepared by Kara Judson, M.D.

This 50-year-old woman has a history of left mastoid surgery in 1972. The patient was uncertain whether this was for chronic infection or cholesteatoma or both. Since then she has had recurrence of aural polyps and 2 surgeries have been done to remove these (the latest one approximately one year ago). Now she complains of a constant sense of moisture and itching in the left ear. She also has some mild pain and popping in the right ear. She is using a hearing aid in the left ear but finds that it worsens her moisture buildup. She also has a hearing loss in the right ear. Nothing makes her symptoms better or worse. They are for the most part constant.

On exam the right external auditory canal was intact and clear. The tympanic membrane was scarred. On the left side, she had a canal-wall-down mastoid cavity. The meatus was small. Moisture was trapped in the cavity. The tympanic membrane is nearly totally perforated with a small margin of remnant drum circumferentially.

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