What is indicated by foul-smelling ear discharge and facial nerve weakness?

Foul-smelling ear discharge combined with facial nerve weakness strongly indicates the presence of a cholesteatoma. Cholesteatomas are abnormal skin growths that can develop in the middle ear and are often a consequence of repeated ear infections or eustachian tube dysfunction. As they grow, cholesteatomas can erode the surrounding bone and structures, including the facial nerve, leading to facial paralysis or weakness, which is a notable complication.

The discharge associated with cholesteatoma is typically foul-smelling due to bacterial infection and the breakdown of tissue. This, combined with the facial nerve involvement, highlights the destructive nature of the condition and the complications that can arise if it is left untreated. Proper diagnosis and surgical intervention are often required to address both the cholesteatoma and any associated complications, such as the impact on the facial nerve.

In contrast, while otitis media can lead to discharge, it usually does not result in facial weakness. Aural polyps may cause discharge but aren't typically associated with facial nerve issues unless there are severe complications. Lastly, eustachian tube dysfunction commonly causes fluid buildup and discomfort rather than the characteristic foul discharge and nerve weakness seen in cholesteatoma.