Review Question - QID 109192

A 5-year-old boy is brought in by his mother for ear discharge. His mother reports that the patient was in his usual state of health until two weeks ago when he developed a “cold,” with a cough and sinusitis. She reports that his symptoms have since resolved. Then two days ago, the patient started to complain that his left ear felt “full.” His mother reports she tried to clean his ear out with a cotton swab. Then this morning, his mother noticed foul-smelling ear discharge coming from his left ear. His past medical history is significant for asthma and recurrent otitis media. The patient’s temperature is 97°F (36.1°C), blood pressure is 110/63 mmHg, pulse is 90/min, and respirations are 22/min with an oxygen saturation of 99% O2 on room air. Upon visual examination of the patient's left ear you appreciate Figure A. During pneumatic otoscopy, the mass does not move with the tympanic membrane. What is the most likely explanation for these findings?