1. Disorders of the Outer Ear
During otoscopy, there many visual
abnormalities which may be revealed.
For now, we will review some of the
more common conditions.

2. Disorders of the Outer Ear
 Atresia
Most atresia is congenital in nature
and associated with various
syndromes.
Atresia is a malformation of the pinna
or external auditory meatus.

3. Disorders of the Outer Ear
 Otic Atresia
This is a common form of atresia
where the ear canal is not formed.
However, all the components of the
middle ear are completely formed.
This may occur for one or both ears.

4. Disorders of the Outer Ear
 Atresia
A couple of common syndromes
associated with congenital atresia
are:
1. Treacher Collins syndrome
2. CHARGE syndrome

5. Disorders of the Outer Ear
 Stenosis
Is a narrowing of the ear canal. It is
not commonly associated with any
hearing loss or syndrome.
A stenotic ear canal condition may
result in excessive cerumen
accumulation and challenges to
hearing instrument fittings.

6. Disorders of the Outer Ear
 External Otitis
This condition is most commonly
found within our patient/client
population. It is sometimes known as
“swimmers ear”.

7. Disorders of the Outer Ear
 External Otitis
Acute cases will present with a red
swollen ear canal with some
discharge. This is a very painful
condition and should be referred to a
physician for proper treatment.

8. Disorders of the Outer Ear
 External Otitis
Besides water trapped in an ear
canal, external otitis may result from
an allergic reaction to the earmold or
hearing instrument materials.

9. Disorders of the Outer Ear
 External Otitis
If this condition is untreated over
time, the infection will deteriorate the
temporal bone, invade the brain, and
result in death. i.e. osteomyelitis of
the temporal bone.

10. Disorders of the Outer Ear
 Otomycosis
During otoscopy you may observe
small mushrooms growing inside the
ear canal. The spores from this
fungus spread rapidly, so make
certain all equipment is immediately
sterilized.

11. Disorders of the Outer Ear
 Osteomas & Exostoses
They are often benign bony growths
found inside the ear canal. They
should be observed for abnormal
growth rate and noted in the chart.

12. Disorders of the Outer Ear
 Osteomas & Exostoses
If hearing loss is present with this
condition, or if they are unusually
large or occluding the ear canal,
physician referral is recommended.

13. Disorders of the Outer Ear
Let’s review the Martin CD to
view various external ear
pathologies.

14. Disorders of the Outer Ear
 Cerumen aka Earwax
Excessive cerumen can create great
difficulties with the use of hearing
instruments. This condition should
be monitored and referred
appropriately.

15. Disorders of the Outer Ear
 Cerumen aka Earwax
Tympanometry is a good test to
perform when uncertain about
eardrum perforations or completely
occluded ear canals.

16. Disorders of the Outer Ear
 Tympanic membrane (Eardrum)
Perforations of the TM are not always
easily observed by otoscopy.
Tympanometry will reveal even the
smallest of perforations.
Note: Some perforations do not always
result in measurable hearing loss.

17. Disorders of the Outer Ear
 Tympanic membrane (eardrum)
Chronic middle ear infections can
thicken and scar the TM. The TM will
have a white appearance.

18. Disorders of the Outer Ear
 Tympanic membrane (eardrum)
A condition where calcium deposits
form upon the TM and have spotty
white patterns exhibited, is identified
as tympanosclerosis. Hearing loss
may or may not be associated with
this condition.