This document discusses various conditions affecting the external ear, including congenital deformities, traumatic injuries, and inflammatory conditions. It covers topics like perichondritis, fungal infections like otomycosis, furuncles, eczema, and cerumen impaction. For each condition, it describes etiology, symptoms, examination findings, and treatment approaches.

1. Dr. AJAY MANICKAM
JR – DEPT OF ENT
RG KAR MEDICAL COLLEGE

2. Congenital
Traumatic
Inflamatory

3.  Bat ear – abnormally
protruding ear.
surgically corrected
after 6 years of age
 Preauricular
appendages
 Preauricular sinus
 Anotia
 Macrotia
 Microtia

4.  Haematoma of the
auricle
 Lacerations /
avulsion of pinna
 Frostbite
 Keloid of the auricle

5.  Perichondritis
 Relapsing polychondritis
 Chondrodermatitis
nodularis chronica helicis

6.  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

7.  Antibiotics based
on C/S
 Local aluminium
acetate
application
 I & D, insertion of
drainage tube
with multiple
openings
 Pressure bandage

8.  Congenital
 Trauma
 Inflamation
 Tumours
 miscellaneous

9.  Congenital
1. Atresia of ear canal
2. Collaural fistula
 Traumatic
1. Lacerations minor &
major

10.  Acute inflamation of skin lining EAC
 2 aetiology
 Infective
1. Bacterial – furuncle / malignant OE
2. Fungal – otomycosis
3. Viral – herpes zoster oticus / OE
haemorrhagica
 Reactive
1. Eczematous
2. Seborrhoeic
3. Neurodermatitis

11.  Fungal infection
affecting external ear
 Diabetes &
immunocompromised
factors – predisposes
 MC- Aspergillus niger
(black headed)–
 others – candida
albicans (white),
aspergillus fumigatus
(green/brown)

12.  Irritation
 Pain
 Deafness
 Itching
 Discharge sometimes
 Ear swab – C/S, blood
sugar estimation

13.  Thorough cleaning –
syringing/ suction
 Painting with 2%
salicylic acid
 Anti fungal drops eg –
nystatin
 Keep ear dry
 Treatment of
underlying disease
(diabetes)

14.  Inflamation of hair follicles –
staphylococcus aureus -
pseudomonas & proteus
 May spread subcutaneously
– cause cellulitis
 Etiology - Scratching ear
canal , allergy ,
immunocompromised
patients, diabetes ,
depression

15.  Pain
 Deafness
 Discharge – purulent
 Tenderness on moving
pinna or pressing
tragus
 Treatment
1. 10% icthymol glycerin
paint – 2 to 3 times
2. Antibiotics ,
analgesics
3. Prevent recurrence

16.  Pseudomonas infection
 Diabetics /
immunosuppresed
 Facial nerve
involvement is common
 May involve skull base,
jugular foramen
 CT scan – to know its
extent

17.  IV antibiotics –
tobramycin, ticarcillin,
3rd gen cephalosporins
6 – 8 weeks
 Control diabetes
 Surgical debridement
of devitalised bone &
tissue to be done
judiciously.

18.  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 formation
2. Less oily
3. Narrow canal
4. Hot & dry climate
5. Stiff hair in EAC
6. Apprehensive patients

19.  Symptoms
1. Deafness
2. Irritation & itching
3. Otalgia
4. Tinnitus
5. Cough reflex
 Treatment
1. Waxolytic agents
2. Syringing
3. Hooking with hook or
forceps

20.  Non living
 Living
Methods of removal
1. Forceps
2. Syringing
3. Suction
4. Microscopic removal
5. Post aural approach