بسم الله الرحمن الرحيم. ANATOMY OF THE EAR EXTERNAL EAR Auricle External Canal.
Diseases of the external ear
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Transcript of Diseases of the external ear
Diseases of the external ear
Dr. AJAY MANICKAMJR – DEPT OF ENTRG KAR MEDICAL COLLEGE
Diseases of pinna
Congenital Traumatic Inflamatory
Congenital
Bat ear – abnormally protruding ear. surgically corrected after 6 years of age
Preauricular appendages
Preauricular sinus Anotia Macrotia Microtia
Trauma
Haematoma of the auricle
Lacerations / avulsion of pinna
Frostbite Keloid of the
auricle
Inflamatory conditions
Perichondritis Relapsing
polychondritis Chondrodermatitis
nodularis chronica helicis
Perichondritis pinna
Inflamation of perichondrium with pus between perichondrium and cartilage
Pseudomonas / staphylococcus aureus
Burning sensation of ear, painful movement of the ear
Fever Body ache Pinna totally deformed –
cauliflower
Perichondritis management
Antibiotics based on C/S
Local aluminium acetate application
I & D, insertion of drainage tube with multiple openings
Pressure bandage
Diseases of external auditory canal Congenital Trauma Inflamation Tumours miscellaneous
Congenital and traumatic Congenital 1. Atresia of ear
canal2. Collaural fistula Traumatic 1. Lacerations minor
& major
Otitis externa Acute inflamation of skin lining EAC 2 aetiology Infective 1. Bacterial – furuncle / malignant OE2. Fungal – otomycosis3. Viral – herpes zoster oticus / OE
haemorrhagicaReactive 1. Eczematous 2. Seborrhoeic3. Neurodermatitis
Otomycosis Fungal infection
affecting external ear Diabetes &
immunocompromised factors – predisposes
MC- Aspergillus niger (black headed)–
others – candida albicans (white), aspergillus fumigatus (green/brown)
Presentation
Irritation Pain Deafness Itching Discharge
sometimes Ear swab – C/S,
blood sugar estimation
Otomycosis treatment
Thorough cleaning – syringing/ suction
Painting with 2% salicylic acid
Anti fungal drops eg – nystatin
Keep ear dry Treatment of
underlying disease (diabetes)
Furunculosis Inflamation of hair follicles
– staphylococcus aureus - pseudomonas & proteus
May spread subcutaneously – cause cellulitis
Etiology - Scratching ear canal , allergy , immunocompromised patients, diabetes , depression
Frunculosis Pain Deafness Discharge – purulent Tenderness on moving
pinna or pressing tragus
Treatment1. 10% icthymol glycerin
paint – 2 to 3 times 2. Antibiotics , analgesics3. Prevent recurrence
Malignant otitis externa Pseudomonas infection Diabetics /
immunosuppresed Facial nerve
involvement is common
May involve skull base, jugular foramen
CT scan – to know its extent
Management
IV antibiotics – tobramycin, ticarcillin, 3rd gen cephalosporins 6 – 8 weeks
Control diabetes Surgical
debridement of devitalised bone & tissue to be done judiciously.
Miscellaneous Wax / cerumen
Mixture of ceruminous and sebaceous gland with desquamated epithelium in EAC
Functions – anti bacterial action , traps dust and foreign body
Causes of excess wax collections
1. Excess formation2. Less oily3. Narrow canal4. Hot & dry climate5. Stiff hair in EAC6. Apprehensive patients
Impacted Cerumen symptoms & management Symptoms 1.Deafness 2. Irritation & itching3.Otalgia4.Tinnitus5.Cough reflex Treatment1.Waxolytic agents2.Syringing3.Hooking with hook
or forceps
Foreign bodies of ear
Non living Living Methods of removal 1. Forceps2. Syringing3. Suction4. Microscopic removal5. Post aural approach