1. Disorders Friday!!!! Or Fear & Loathing in the Outer Ear

2. 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)

6. 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

8. 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