Ear pathology Clockwise: normal eardrum, cauliflower ear, otitis externa, microtia, tympanorrhexis, otomycosis

Tinnitis- it’s a symptom Tinnitis- means “ringing ear,” but patients may hear roaring, clicking, or hissing Technically means hearing sounds no one else does Indicates some damage to hair cells (inner ear) Temporary or long term Could be circulatory (ex/ high blood pressure) https://www.youtube.com/watch?v=U0SGBN8LAVU

Cauliflower ear After external trauma to auricle Common in boxers Inflammation separates skin from cartilage Clots can cause cartilage to die & fold in on itself Scar tissue makes lumps more prominent When blood flow is blocked, the affected cartilage may die and, without the supportive tissue, fold in on itself. Scar tissue may form, contributing to a swollen and deformed look. Over time, the effects may become more prominent, and they may be permanent. The good news is that cauliflower ear can usually be prevented, even after such an injury occurs.

Tympanorrhexis Ruptured eardrum Pain Small tears will heal Larger tears may be patched with surgical paper Tympanoplasty- surgical repair by grafting tissue https://www.youtube.com/watch?v=jbv6U0zdHiU

Otitis media Most common ear infection Middle ear fills with fluid (normally just air) Pain, pressure, swollen tympanum Fluid comes from infection in nasal region via Eustachian Tube (ET) Or gets trapped in middle ear bc ET swells shut Treat with time, analgesics (NSAIDs, Tylenol) and possible Abx https://www.youtube.com/watch?v=2lbODZYg8zs

Why do kids get more ear infections than adults? Kids have shorter, straighter ET Immune systems in kids are still developing

Otitis externa Swimmer’s ear Excessive moisture (& excessive earwax remover) changes acidity of skin in ear canal Moisture softens skin allowing bacteria to seep in Redness, clear or purulent discharge, pain Narrowing of canal due to swelling May be difficult to see eardrum, but eardrum should be clear/normal Treat with cleaning and topical Abx Preventative drops/drying agents use vinegar (restores acidity), and alcohol (dries)

Diagnose me: http://www.discoverylife.com/tv-shows/diagnose-me/videos/the-sounds-her-body-makes-are-magnified-in-her-ears/

Patulous Eustachian tube Eustachian tube remains abnormally open all the time Causes autophony (hearing your own voice or breathing in your head) Clue in diagnosis- this goes away if patient lays flat on back or bends all the way over Treatment- Eustachian tuboplasty (salpingoplasty) to reduce the size of the tube

Labrynthitis Vestibular neuritis or otitis interna Viral or bacterial Results in imbalance of neural input from L and R ears Causes vertigo, tinitis, nausea

Diagnose me: https://www.youtube.com/watch?v=If9KErIUFjw Turn off sound- endoscopy (perforated ear) tympanorrhexis

Microtia Abnormally small ears