What is the Diagnosis?

I love this weeks Image Challenge from The New England Journal of Medicine because I had a patient with these exact findings about a month ago.  You be the doctor and make your best guess for the diagnosis.  Post a comment and check back for the answer tomorrow.

This patient presented with hearing loss and left ear fullness.  What is the diagnosis? (click on the image for a better view)

1.  Cholesteatoma
2.  Fracture of the temporal bone
3.  Ochronosis
4.  Otomycosis
5.  Relapsing polychondritis 

Winner gets bragging rights at your next cocktail party!


Guboy said…
OK, Toni - While just a non-clinical Sutter West Bay Regional marketing guy, this one looks obvious to me. I'm putting $10 on "Fracture of the temporal bone."
Unknown said…
With my Latin terminology coming into play I'm going to say #4!
Rudi V said…
Cholesteatoma. Note scar. Recurrence?
Anonymous said…
That looks a lot like battle sign...so I'm going with fracture of the temporal bone
Anonymous said…
I think it is number 3. Can't wait to see....
Serena Outland said…
That is serious! I’d go with number 4, which is Otomycosis. This is an external fungal infection that is usually cause by too much use of cotton swabs and other hearing aids. To prevent any ear infection, I suggest that, before showering, always keep your ears dry. Flex your head left and right to let the water run out of your ears. With this simple method, you can prevent any bacteria from forming inside your ear.

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