Osteoma – May 9, 2024

Osteoma – May 9, 2024

A healthy 48-year-old man from Finland visited the WiscMed booth at the Pediatric Academic Society conference in Toronto. He has no ear or hearing concerns (other than spousal selective hearing).


The following image of his ear drum was obtained with the WiscMed Wispr digital otoscope.

Which of the following is true?

  1. The patient has a history of ear infections.
  2. The patient has had consistent exposure to cold water.
  3. The ear is normal.
  4. The patient has a benign finding that does not require further action.

Answer D. The patient has a benign finding that does not require further action.

The patient has two benign findings that require no action. First is an osteoma. This is a benign growth of bone in the external ear canal. It often appears pedunculated. It has no clinical significance unless it is large enough to interfere with hearing or cause external otitis. Second is a pseudo retraction of the pars flaccida portion of the tympanic membrane (TM). The TM normally “drapes” over the anterior-superior portion of the drum. In this case, the TM is retracted, likely an anatomic finding associated with a slightly more horizontal malleus.

Consistent exposure to cold water such as a surfer may experience often causes exostosis. This is also a benign growth of the bone in the external ear canal. Exostosis is generally further from the ear drum and has a broader base than an osteoma.

There is no sclerosis as would be found in someone with a history of ear infections and ear tubes.

Here is the complete video exam.


Carbone PN, Nelson BL. External auditory osteoma. Head Neck Pathol. 2012 Jun;6(2):244-6. doi: 10.1007/s12105-011-0314-7. Epub 2011 Dec 20. PMID: 22183765; PMCID: PMC3370017.