Treatment of Persistent Deep Infection After Total Ear Canal Ablation and Lateral Bulla Osteotomy

Persistent deep infection originating from remnants of an incompletely excised ear canal, or epithelium and debris left in the osseous ear canal or tympanic cavity after surgery total ear canal ablation and lateral bulla osteotomy can be debilitating. Clinical signs including pain elicited on deep palpation over the affected bulla or when opening the mouth, or draining sinuses may be delayed months to years. Localization of the nidus via CT imaging is important for surgical planning. Although antibiotic therapy usually reduces or eliminates the clinical signs of deep infection, relapses are common. Surgery more consistently results in permanent resolution.