Idiopathic osteitis of the tympanic bone is encountered in elderly patients. The symptoms are usually mild and on examination once covers a defect in the epithelium of the floor of the deep external auditory canal with exposed bone seen here. It is believed that this is usually the result of trauma from self cleansing. over time this necrotic bone will ultimately separate and be extruded as a sequestrum. With luck the underlying area will re-epithelize as will be seen in another photograph.
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