A man with a lesion in his ear

42 y, white man, with recurrent lt ear infections, h/o myringotomy in childhood, comes in c/o otalgia, purulent otorrhea, deafness, vertigo and constant headache. Exam findings are displayed in the picture
Owing to insurance issues, he hasn’t been seen by a physician for almost 2 years.

Which of the following statements is false?

1. It seems that he has otitis externa from this hearing aid, it needs to be replaced (Correct Answer)
2. He is likely to have conductive hearing loss
3. The pathology in the picture can herald the presence of a cholesteatoma
4. A CT scan of the temporal bone is a part of management of his current problem.
5. He needs a referral to the ENT specialist for surgical treatment