A 35-year-old male presents to urgent care with gradual onset of left-sided facial pain. The pain is worse with the manipulation of the ear lobe, yawning, and chewing. The examination of the left ear reveals this image.
The patient appears to have exostosis, abnormal growth of bone, in this case in the ear canal. This condition is often associated with people that have extended exposure to cold water – for example, surfers. Exostosis is generally slow to advance and is usually painless. Given that this patient is symptomatic, further investigation is warranted. The next step in evaluation could be either imaging via a CT scan of the temporal bones or a consult with otolaryngology.