Severe ear pain that worsens at night and with chewing, accompanied by an edematous external auditory canal indicates what condition?

The condition characterized by severe ear pain that intensifies at night and with chewing, alongside an edematous external auditory canal, is indicative of necrotizing otitis externa. This condition, also known as malignant otitis externa, primarily affects individuals with compromised immune systems, such as the elderly or those with diabetes. The intense pain associated with necrotizing otitis externa is often disproportionate to the physical findings, and the swelling or edema of the external auditory canal is a hallmark sign.

In necrotizing otitis externa, the infection typically spreads to the deeper structures of the ear canal, including the surrounding tissues, and can present with significant inflammation. This condition often requires aggressive treatment with antibiotics or even surgical intervention to manage any necrotic tissue.

The other conditions listed do not present with the same combination of symptoms. For instance, acute otitis media typically presents with fever and ear fullness rather than external canal edema, chronic otitis externa may involve recurrent itching and less severe pain, and external auditory canal trauma would likely be associated with a history of injury without the severe systemic features of necrotizing otitis externa.

Understanding these nuances helps clarify why necrotizing otitis externa is the correct diagnosis in this scenario based on the described