diseases of the external ear
TRANSCRIPT
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Diseases of the external ear
Dr. AJAY MANICKAMJR – DEPT OF ENTRG KAR MEDICAL COLLEGE
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Diseases of pinna
Congenital Traumatic Inflamatory
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Congenital
Bat ear – abnormally protruding ear. surgically corrected after 6 years of age
Preauricular appendages
Preauricular sinus Anotia Macrotia Microtia
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Trauma
Haematoma of the auricle
Lacerations / avulsion of pinna
Frostbite Keloid of the
auricle
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Inflamatory conditions
Perichondritis Relapsing
polychondritis Chondrodermatitis
nodularis chronica helicis
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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
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Perichondritis management
Antibiotics based on C/S
Local aluminium acetate application
I & D, insertion of drainage tube with multiple openings
Pressure bandage
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Diseases of external auditory canal Congenital Trauma Inflamation Tumours miscellaneous
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Congenital and traumatic Congenital 1. Atresia of ear
canal2. Collaural fistula Traumatic 1. Lacerations minor
& major
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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
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Otomycosis Fungal infection
affecting external ear Diabetes &
immunocompromised factors – predisposes
MC- Aspergillus niger (black headed)–
others – candida albicans (white), aspergillus fumigatus (green/brown)
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Presentation
Irritation Pain Deafness Itching Discharge
sometimes Ear swab – C/S,
blood sugar estimation
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Otomycosis treatment
Thorough cleaning – syringing/ suction
Painting with 2% salicylic acid
Anti fungal drops eg – nystatin
Keep ear dry Treatment of
underlying disease (diabetes)
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Furunculosis Inflamation of hair follicles
– staphylococcus aureus - pseudomonas & proteus
May spread subcutaneously – cause cellulitis
Etiology - Scratching ear canal , allergy , immunocompromised patients, diabetes , depression
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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
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Malignant otitis externa Pseudomonas infection Diabetics /
immunosuppresed Facial nerve
involvement is common
May involve skull base, jugular foramen
CT scan – to know its extent
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Management
IV antibiotics – tobramycin, ticarcillin, 3rd gen cephalosporins 6 – 8 weeks
Control diabetes Surgical
debridement of devitalised bone & tissue to be done judiciously.
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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
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Impacted Cerumen symptoms & management Symptoms 1.Deafness 2. Irritation & itching3.Otalgia4.Tinnitus5.Cough reflex Treatment1.Waxolytic agents2.Syringing3.Hooking with hook
or forceps
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Foreign bodies of ear
Non living Living Methods of removal 1. Forceps2. Syringing3. Suction4. Microscopic removal5. Post aural approach
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