On probing, the mass was soft, insensitive, did not bleed, and obscured the tympanic membrane and the tuning fork test showed conductive hearing loss on the left side. On inspection, there was a 2-cm, skin-covered, sessile, globular mass attached to the posterosuperior part of the cartilaginous EAC covered with purulent discharge (Fig. Her complaints started after she had encountered trauma to her left ear, while she was chopping firewood at work. She also noticed a growth in the external ear for a 1-year duration that slowly increased in size to attain the present size. Hence, we emphasize the importance of history taking and consider a neglected foreign body as one of the differential diagnoses for an aural mass and plan for a surgical excision when they do not respond to antibiotics.Ī 49-year-old female, a farmer by occupation, presented to our ENT outpatient department with complaints of persistent, progressive, purulent foul-smelling left ear discharge and hearing loss for 1 year. There are similar case reports available in the literature, but in our case report, despite adequate history, examination, and appropriate investigations, we discovered the neglected foreign body per operatively only. We report a case of an aural mass that was secondary to a neglected foreign body and was discovered during surgical excision of the same. Imaging studies and FNAC (fine needle aspiration cytology) may lead to diagnosing the underlying pathology and help us to narrow down the spectrum of various other causes of an aural mass. These neglected foreign bodies in EAC that present as an aural mass usually do not respond to treatment with antibiotics until they are discovered using appropriate investigations and removed surgically. Neglected foreign bodies of the external auditory canal (EAC) can present as an aural mass which can also present with otalgia, otorrhea, aural fullness, hearing loss, granulation tissue, and aural polyp. Hence, we suggest that we need to consider an underlying neglected foreign body as a cause, whenever masses of EAC do not respond to appropriate medical treatment with antibiotics. In our case report, we report a neglected foreign body in the external auditory canal that presented as an EAC mass and its management. The management of an external auditory canal mass will vary in each case, depending upon the underlying pathology and the extent of the involvement of the surrounding structures. The most common causes of external auditory canal masses are due to otitis media-squamous and mucosal types, tubercular otitis media, malignant otitis externa, and benign tumors like osteomas, exostosis, pleomorphic adenoma, tumors from the ceruminous and sebaceous glands and malignant tumors like squamous cell carcinoma and rhabdomyosarcoma. External auditory canal (EAC) masses can arise secondary to a multitude of ear pathologies like congenital, inflammatory, infective, or malignancy.
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