Disorders of the Outer Ear

Conductive hearing loss results from abnormalities of the external and or middle ear. Sound is not readily transmitted or conducted through air, bone, or tissue because of the abnormality.

Sensory/neural hearing loss results from damage to the inner ear and or auditory nerve. No medical intervention can help.

Mixed hearing loss is a combination of conductive and sensory/neural hearing loss.

Disorders-

Atresia (closure) of the external ear canal and a malformed or missing pinna.

Impacted cerumen is a cause of conductive hearing loss. Must be referred for cerumen removal.

Do not fit a hearing aid until cerumen plus is removed.

Polyps are masses of tissue that grow outward from a surface. Any polyp, lump or bony growth should be considered a reason for referral.

Two types of benign bony growths in the external canal: osteomas and exostoses. Osteomas arise from any region in the external ear canal. Exostoses are more likely to be bilateral and caused by prolonged exposure to cold water, most common in surfers, divers, and swimmers.

Prolapsed or collapsed canal is a breakdown or sag of tissue around the canal. Causes the walls of the canal to collapse, partially or completely blocking the external ear canal.

Perforations are holes in the TM. Can be caused from middle ear infections, cholesteatoma, foreign object damage, a bone fracture, a traumatic noise exposure or a blow to the ear. Perforations with drainage require a medical referral.

Monomeric spots may look like TM perforations. These spots are the result of holes that have healed without the fibrous layer.

Tympanic membrane scarring can result from healed perforations or recurrent middle ear infections. Can cause conductive hearing loss. Tympanoaclerosis is a hardening of the TM caused by calcium deposits. Appears opaque, white, and chalky.

Otitis externa is an inflammation of the walls of the external auditory canal. Eczema or dermatitis can cause pinna to be itchy and painful.