Disorders Disorders Friday!!!!Friday!!!!

Or Fear & Loathing in the Or Fear & Loathing in the Outer EarOuter Ear

Outer Ear Disorder 1Outer Ear Disorder 1• Symptoms

– Ear red & swollen– May be some watery discharge– Acute or chronic– Diffuse or localized– Typically mild

• Population– Swimmers

• Ear constantly moist– Anyone (most common ailment)

• Scratching or irritation to area• Fungal

• Diagnosis– Otitis Externa – Keep dry, use topical antibiotics

• Very treatable, 1 week recovery

Outer Ear Disorders 2Outer Ear Disorders 2• Symptoms

– Colored ear• Black (85%), yellow, gray, white,

blue-green• Itchy

– Wet or full feeling– Initially mild hearing loss, may be

progressive• Population

– Recent users of antibiotics– Residents of very hot, humid

environments• Diagnosis

– Otomycosis (special case of Otitis Externa)

– Keep dry, use topical antibacterial• More difficult treatment

Outer Ear Obstruction 1Outer Ear Obstruction 1• Symptoms

– Better hearing in Sound Field than Earphone

– Soft cartilage– Moderate hearing loss, especially with

high frequencies

• Population– Older adults

• Diagnosis– Collapsed ear canal

• Obstruction blocks sound• Ear collapses with earphones

– Ear may be held open, but the problem is chronic

Obstruction 2Obstruction 2• Symptoms

– Cerumen build-up (otoscope)– Itching, irritation– Mild to moderate conductive

hearing loss– Mild tinnitus (rare)

• Population– Anyone

• Asian (dry) vs. Euro-African (wet) cerumen?

• Diagnosis– Impacted Cerumen– Treatment Irrigation

• May cause middle ear infection, require multiple attempts

– Softening Drugs (see Guest et al., 2004)

Neoplasms 1Neoplasms 1

• Symptoms– Fullness (possible pain)– Otoscopic inspection shows growth– Unilateral mild conductive hearing

loss

• Population– Anyone

• Older adults

• Diagnosis– Exotoses/Osteomas – bony tumors

• Benign

– May be removed with surgery

Neoplasms 2Neoplasms 2• Symptoms

– Fullness– Mild conductive hearing loss– Otoscopic inspection shows

blockage• Purple growth

• Population– Infants, less than 2 months of age

• Diagnosis– Hemangiomas – Blood filled

growth• If unusual size may displace

structures• Blockage of the Meatus• Very RARE

– Treatment• Self resolving (age 5)• Steroids

Outer Ear Disorders – Big Outer Ear Disorders – Big PicturePicture

• Infections & blockages– Typically mild conductive hearing loss– Less than 10 dB HL difference

• Neoplasms– Growths with low risk of affecting

hearing