Disorders Friday!!!!

1
Disorders Friday!!!!

• Or Fear Loathing in the Outer Ear

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Outer 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

3
Outer 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

4
Outer 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

5
Obstruction 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)

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Neoplasms 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

7
Neoplasms 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

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Outer Ear Disorders Big Picture

• Infections blockages
• Typically mild conductive hearing loss
• Less than 10 dB HL difference
• Neoplasms
• Growths with low risk of affecting hearing