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CONGENITAL CONDITIONS
• Causes : Heridity , Drugs , Irradiation , Viral Infection ,…
Crux anhihelics
is poorly formed
Cup Ear
Antihelix is undeveloped
ACCESSORY AURICLES
• Small elevation of skin containing a bar of elastic
cartilage.
• Excision
• Faulty fusion of 1st & 2nd arch
• Opening :
1) Anterior border of ascending limb of helix
2) Line extending b/w tragal notch & angle of mouth
3) Pinna (or) Lobule
• Classification
• Erysipelas of External ear ( Inf. of overlying skin)
Thickening of perichondrium ,
Pruritus
Induration
Edema
Advanced cases
Crusting & weeping
• Pathogen: S. aureus
FURUNCULOSIS
SIGNS
• Edema
• Erythema
• Tenderness
• Occasional fluctuance
DD - Ac.mastoiditis
FURUNCULOSIS
SYMPTOMS
• Localized pain
• Ear blockage
• Exudates a scanty sero-sanguinous discharge
• Pinna & tragus – tender on palpation
• Pruritus
• Hearing loss (if lesion occludes canal)
TREATMENT
• Local heat
• Analgesics
• Oral & systemic anti-staphylococcal antibiotics
• Topical ( antibiotics , Hygroscopic Dehydrating agents)
• Incision and drainage reserved for localized abscess
• IV antibiotics for soft tissue extension
• For recurrent : Eradication theraphy with nasal mupirocin ,
oral flucloxacillin (14 days), Bacterial interferance theraphy
OTOMYCOSIS
• Fungal infection of EAC skin
• Dull pain
• Tinnitus
OTOMYCOSIS
• Canal erythema
• Mild edema
( wet newspaper)
Aspergillus Candida
OTOMYCOSIS
TREATMENT
• Thorough aural toilet & removal of debris
• Topical antifungals
Symptoms
• Pain
• Increased pruritus
Signs
• Erythema
• Increasing edema
• Canal debris, discharge
AOE: SEVERE STAGE
Signs
• Lumen obliteration
• Purulent otorrhea
• Involvement of
periauricular soft tissue
AOE: TREATMENT
Frequent canal cleaning ( Aural Toilet )
• Unrelenting pruritus
• Hypertrophied skin
• Mucopurulent otorrhea
COE: TREATMENT
• Topical antibiotics, frequent cleanings
• Topical Steroids
• Surgical intervention
• Failure of medical treatment
• To enlarge and resurface the EAC
GRANULAR MYRINGITIS
Localized chronic inflammation of pars tensa with granulation
tissue with possible involvement of EAC
Granular Myringitis
• No hearing loss
• No significant pain
• TM obscured by pus
• Posterio-superior granulations
• No TM perforations
GRANULAR MYRINGITIS
• Multiple reddened,
inflamed blebs
• Hemorrhagic vesicles
BULLOUS MYRINGITIS
• Sudden , unilateral throbbing pain
• Hearing loss
Otoscopy
Analgesics
• Chronic otorrhea
• Aural fullness
• Pruritis
• Hearing loss
NECROTIZING OTITIS EXTERNA
• Purulent secretions
• Audiometry
• Pain control
• Surgical debridement
MALIGNANT OTITIS EXTERNA
• Cellulitis and inflammation of the external auditory
canal and skull base ( temporal bone )
• Elderly diabetics
• Males
CONTROL OF DIABETES
SURGERY
• Extensive surgical procedures have failed miserably to
pinna.
• Corneal protection
• Anti virals
KERATOSIS OBTURANS
Tm – intact
Dry phenotype
• Mangaloid races
Deafness
Tinnitus
Reflex cough
Ear ache
Fullness
Vertigo
TREATMENT
• Ceruminolytics (para-di-chloro-benzene)
• Syringing
• Papilloma
• Viral Papilloma - outer meatus
• Diffuse Papilloma
• Local Excision
BENIGN TUMOURS
• Adenoma
• Ceruminoma ( Hidradenoma)
• Arise from modified apocrine sweat gland
• Blocking sensation
• Wide Excision
SQUAMOUS CELL CA
• Indurated ulcer with everted margins