Normal Ear

A typical normal ear.

Acute Ear Infection without Pus

A typical acute ear infection of the middle ear. You can see the redness involving the eardrum and ear canal skin around the eardrum. More info.

Acute Ear Infection with Pus

A typical acute ear infection of the middle ear. You can see the purulent fluid behind the eardrum causing a slight "bulging" appearance. More info.

Cholesteatoma

A cholesteatoma is a destructive and expansile mass composed of skin debris. Surgical correction is required. They often become infected causing a persistent or recurrent ear infection with drainage.

Granulation Tissue

Often associated with a chronic ear infection with blood-tinged drainage, granulation tissue appears as a very red fleshy mass in the ear canal. Treatment almost always require steroids whether oral or ear drops.

Earwax

Run of the mill earwax. More info.

Acute Otitis Externa (Swimmer's Ear)

Characterized by severe pain and swelling of the ear canal due to an infection of the ear canal's skin. The eardrum typically is not able to be visualized due to the profound swelling of the ear canal opening.

Hemotympanum

A hemotympanum is when blood is present behind the eardrum. This may happen with severe nosebleeds or barometric trauma from sudden pressure changes.

Serous Otitis Media

When fluid is present behind the eardrum, this will cause a conductive hearing loss that is reversible. Such fluid buildup commonly occurs after a resolved ear infection or with eustachian tube dysfunction. The fluid itself looks like apple juice.

Tympanosclerosis

Eardrum scar tissue or tympanosclerosis may develop if frequent ear infections have occurred at some point in the remote past. Normally without any significance.

Retracted Eardrum

When significant negative pressure develops within the middle ear, the eardrum will get sucked inward. When this happens, the eardrum drapes over the middle ear bones as well as the middle ear walls causing them to appear in stark contrast. In this picture, one can clearly see not only the malleus, but also the incus, stapes, promontory, and even the round window.

Monomeric Eardrum

A normal eardrum actually has 3 layers to it. However, sometimes when the eardrum heals a perforation, a more thinned out "single" layer or monomeric eardrum is created to close the hole. When this happens, it may give the illusion of a persistent hole in the eardrum when in actuality there is no hole.

Ear Drainage (Otorrhea)

Purulent drainage will come out the ear when an ear infection is present and the eardrum ruptures. Almost always, a hole in the eardrum is present when such ear drainage is present and treatment nearly always includes antibiotic ear drops.

Tympanic Perforation

Hole in the eardrum, whether from trauma or infection.

Cartilage Graft after Ear Surgery

When some type of middle ear surgery is performed (ie, ossicular reconstruction) or eardrum hole is repaired via tympanoplasty, a cartilage graft is often placed to reinforce the eardrum tissue to minimize risk of future perforation. Not uncommonly, the cartilage graft may be mistaken for cholesteatoma.

Exostosis

Ear canal osteomas and exostoses are painless and non-cancerous. They are analogous to a foot bunion, but located in the ear. Exostosis typically arise from the front or back of the ear canal bone. It is sessile meaning it looks like a rolling hill. Image from Wikipedia.

Osteoma

Ear canal osteomas are boney growths that arise from the ear canal suture lines. They tend to be pedunculated, hanging from a thin stalk much like a clock pendulum. An osteoma may occur spontaneously, but most are associated with chronic cold water exposure from swimming or surfing while growing up.

Ear Canal Bruising

Often happens with aggressive q-tip use.

Relapsing Polychondritis

Intermittent, recurrent, painful condition whereby the outside cartilage bearing part of the ear turns red and swollen, but the earlobe itself feels and looks normal. This autoimmune condition is due to inflammation of the ear's cartilage.

Auricular Hematoma

Condition where blood collects under the skin. If not drained properly, can lead to cauliflower ear. More info.

Cauliflower Ear

External ear deformity resulting from cartilage damage stemming from untreated hematoma.

Dermatitis

Inflammatory condition resulting in scaly, flaky, and itchy skin. Treated with steroid ointments.

Fungal Otitis Externa

Fungal ear infection of the ear canal typically triggered by inappropriate antibiotic ear drops. There typically is no pain. Itchiness is the main complaint as well as clogging from the ear canal blockage. More info.

Glomus Tympanicum

Unlike granulation tissue which is a vascular mass located in the ear canal associated with ear infections, a glomus tympanicum is a vascular mass located BEHIND the eardrum not associated with ear infections. Treatment requires surgical removal.

Osteonecrosis

Especially in patients with radiation therapy to the ear region for cancer treatment, the ear canal skin may ulcerate to point that the underlying bone becomes exposed.