External Auditory Canal Erosion at the 6 O'clock Spot.

Area of Science:

• Otolaryngology
• Pathology
• Medical Research

Background:

• External auditory canal (EAC) erosion can stem from diverse pathologies.
• Identifying common sites of erosion aids in understanding disease progression.

Purpose of the Study:

• To identify and report a consistent anatomical location of external ear canal erosion across multiple pathologies.
• To investigate the 6 o'clock position as a potential common nidus for EAC pathologies.

Main Methods:

• Observational report of otology patients presenting with EAC erosions in 2023.
• Documentation of erosion sites, specifically focusing on the 6 o'clock location.
• Review of existing literature on EAC pathologies and their origins.

Main Results:

• Eight patients (10 ears) exhibited EAC erosion originating at the 6 o'clock position, medial to the bony-cartilaginous junction.
• No other spontaneous EAC erosion site was identified in the study cohort.
• Literature review indicated the 6 o'clock location as a common origin for keratosis obturans, bisphosphonate-induced osteonecrosis, and necrotizing otitis externa.

Conclusions:

• The "6 o'clock spot" is a prevalent site for EAC erosion, often associated with spontaneous wax and keratin accumulation.
• This specific location may serve as a precursor to more severe conditions including keratosis obturans, bisphosphonate-induced osteonecrosis, and necrotizing otitis externa.