A 60-year-old male with a long history of windsurfing and other ocean sports undergoes an ear exam with the Wispr digital otoscope. Why is the patient’s tympanic membrane (eardrum) so difficult to see?
The patient has significant exostosis. This distorts the external ear canal and makes it difficult to visualize the eardrum.
Exostosis is an abnormal bony growth. The ear canal is a common location for this. Exostosis is caused by frequent exposure to cold water and is commonly seen in active water enthusiasts. Exostosis is not cancer, and generally, no action needs to be taken unless it is so severe that it leads to infection or hearing loss. It is a striking finding when first observed.
The patient reported otitis externa in the left ear about a week before the exam. Symptoms were reported as decreased hearing and a sense of fullness. It was treated with an antibiotic drop. If frequent infections occur, consultation with an ENT specialist would be appropriate.
The patient has bilateral exostosis, perhaps worse on the left side than the right side.
Here are examples of mild, moderate, and significant exostosis. Exostosis generally increases as the exposure to cold water continues.
Here are the complete video exams of the left and right ears: