External Ear DiseaseLesions of the Pinna encountered are:• Hematoma (blood between the cartilage and skin)• Frostbite (portions of the Pinna appear white and feel solid to the touch)• Keloid (excessive scar tissue formation)
External Ear DiseaseInfectious lesions of the Pinna are notcommon. Here are a few:• Cellulitis (infectious inflammation)• Subperichondral abscess (a contaminated wound)
External Ear DiseaseNeoplastic tumors (skin cancers) of thePinna are common. Many are benign—feware malignant.Any lesion which is bleeding, notsymmetrical in shape, or includes variouscolors should be referred to adermatologist.
External Ear DiseaseCongenital lesions represent abnormalshape and size of the Pinna, and/orportions of it.Note: when these abnormalities areobserved, they may provide a possibleclue to defects hidden within the middleear.
External Auditory Canal DiseaseTraumatic disease of the externalauditory canal commonly occur due to thepatient or physician trying to extract aforeign body from the ear canal.Deep lacerations may become infected ifnot treated appropriately.
External Auditory Canal DiseaseThe most common disease condition isExternal Otitis. However, there is a viralcondition—Bullous Myringitis whichreveals an inflamed/red tympanicmembrane and is associated withsensorineural hearing loss.
External Auditory Canal DiseaseSkin cancers may also be found inside theear canal. More commonly found will bebenign growths such as:• Keratosis Obturans (a skin ball)• Exostosis (a nodule of bone covered with skin close to the eardrum)• Osteoma ( a nodule of bone covered with skin found closer to the second bend of the ear canal)
External Auditory Canal DiseaseCongenital abnormalities may be foundregarding the ear canal.Two forms found are:• Membranous Atresia (tissue “plug”)• Bony Atresia (bony “plug”)
Middle Ear DiseaseTrauma of the TM or ossicles often occursfrom: An explosion A puncture A burnNote: A severe enough trauma may also fracture thetemporal bone and result in a fistula (cerebrospinalfluid leak).
Middle Ear DiseaseInfectious disease encountered within themiddle ear are commonly:• Suppurative Otitis Media (either acute or serous)• Acute Mastoiditis (a condition which occurs when otitis media goes untreated)
Middle Ear DiseaseBenign growths may also occur within themiddle ear. Some common growths are:• Cholesteatoma (enlarged section of skin tissue)• Osteomas (benign bony growths)• Glomus Tumors (a reddish-blue mass seen through/behind the eardrum often associated with pulsatile tinnitus)
Middle Ear DiseaseCongenital disease of the middle earoften includes:• Fixation of the Stapes• Ossicles absence• Fusion of ossicles to the temporal bone
Diseases of the Inner EarTrauma and aging include:• Noise induced hearing loss• Presbycusis (old age hearing loss)• Fractures of the temporal bone
Diseases of the Inner EarInfectious disease of the inner ear is eitherviral or bacterial. Sensorineural hearing lossand various forms of labyrinthitis areassociated with this process. They are:• Bacterial labyrinthitis (infection from temporal bone fracture)• Viral labyrinthitis (caused by mumps, measles, influenza)• Syphilitic labyrinthitis (serious form of bacterial either congenital or acquired)
Diseases of the Inner EarBenign growths within the inner eargenerally occur within or along theinternal auditory canal.They are known as:• Acoustic NeuromasNote: A less common benign growth occurringalong the lining of the braincase in known as aMeningioma.
Diseases of the Inner EarCongenital defects fall into three generalcategories. They are:1. Pre-natal (maternal ototoxicity, maternal syphilis, congenital rubella)2. Neonatal (low birth weight, hypoxia, serious infections i.e. meningitis, encephalitis)3. Post-natal (genetic syndromes Northern page #106)
Diseases of the Inner EarTwo common diseases often associatedwith fluctuating hearing loss and affectingthe inner ear are:1. Meniere’s Disease (triad of symptoms i.e. fluctuating hearing, tinnitus, vertigo)2. Multiple Sclerosis (unsteadiness, fluctuating sensorineural HL, and visual disturbances)
We will review more regardingdetailed/specific middle ear diseasesand their treatment later this week.Ototoxicity and its effects upon theinner ear will also be covered.