Clinical Photo of The Week: Vol3,No6

This case was presented in the recent edition (Vol3No6) of otorhinolaryngology news :
A 48-year old male presented with a year history of diminished hearing on the left. He gave a history of left ear canal surgery 10 years earlier. The surgery was to correct post traumatic closure of left ear canal observed following a vehicular accident. Examination revealed the sign shown in this picture. CT-Scan showed normal distal 1/3rd bony canal, normal middle and inner ear, and soft tissue density in the outer 2/3rd ear canal. Audiometry revealed air-bone gap of 15-20dB across speech frequencies.
Diagnosis: Restenosis following initial surgically repaired acquired canal atresia