401 Outer ear pathologies (16)

Anotia

Absent Pinna

• Can test BC (reg) and AC (supraaural headphones)

Microtia

Abnormally shaped pinna

Preauricular pits/sinuses + appendages (tags)

bulbous flabs + holes on earlobe/pinna/tragus.

Stenosis

abnormally small opening/canal

• does NOT cause HL. Malformation can just make it more complicated to treat other ear pathologies.

Atresia

No opening/canal

• correctly shaped pinna, BUT there is no opening at the end of the ear canal.

Treatment for Anotia + Microtia?

Reconstruct pinna/ orthotic pinna

• surgery mostly cosmetic. does not restore hearing.

Treatment for Atresia?

Surgical options depend on specific conditions of middle ear and cochlea.

• surgery mostly cosmetic. does not restore hearing.??

• BAHA (if middle ear + cochlea good)

Bone anchored hearing aid (BAHA)

Metal screw drilled into skull. Fuses with bone.

Delivers sound through bone conduction.

Treatment for Stenosis

May not require medical intervention

Excessive Cerumen: What? cause? how to diagnose? symptoms? Treatment?

What

• most common outer ear disorder

• may have alot of wax without any HL

Cause

• Cerumen pushed down the ear canal so deep that it cant fall out on its own

• individual variables (ex. genetics causing you to build more wax, use of q-tips)

How to diagnose?

• Otoscopy

• Type B Tympanometry with volume <0.2mL

Symptoms

• CHL, otalgia, dizziness/vertigo

Treatment

• ear drops, irrigation, removal (scraper tools)’

Foreign Objects: What? Symptoms?

Things in the ear canal that aren’t supposed to be there.

• does NOT cause CHL unless the object entirely blocks the opening.

Collapsing Ear Canal: What? What age? How to diagnose?

What

• Partial/complete closure of canal when pressure applied to the pinna (bc canal is so soft)

Population

• 10%-33% of adults 65+

• newborns/infants

Diagnosis

• Tympanometry: Type A (normal) but… with a high freq. HL

• Supraaural headphones present with HL but inserts dont (opens up canal)??

Osteomas: What? Unilateral/Bilateral? Symptoms? Treatment?

Bony growths that appear in the inner 1/3 of ear canal (where thin skin and mostly bone)

• Unilateral (usually)

Symptoms

• doesnt cause CHL bc no complete closure

treatment

• surgical removal

Exostoses

Multiple bony growths in inner 1/3 of canal.

• bilateral

Populations

• swimmers who stay mostly in cold water

Treatment

• requires surgical removal

Causes HL?

• no bc no complete closure

Otitis Externa: What? Symptoms? Cause? Treatment?

infection of outer ear (pinna and/or ear canal)

Symptoms:

• may not cause HL

• itching, redness, swelling, otalgia, otorrhea

Cause:

• swim in dirty water, irritated skin with q-tip leaving skin prone to infection

Treatment

• medication

• scooping it out w tool

TM perforation

Tear/hole in TM

Cause

• trauma, excessive pressure build-up in middle ear (lots of earwax build up making neg pressure or fluid build up in middle ear)

Diagnosis

• Type B tympanometry, large VeC

• Otoscopy

Symptoms

• CHL (degree depends on size of perforation)

Treatment

• can heal by themselves

• Severe cases → surgery (Ex. myringoplasty )

• graft (fascia/paper)

Tympanosclerosis: What, Cause, symptoms, diagnosis?

Scarring of TM.

• Cause: frequent infections/trauma

• Symptoms: May or may not cause CHL

Diagnosis:

• Otoscopy

• Tympanometry: normal Type A (barely any scar tissue), Shallow type As, Type B (if so much scarring),