Diseases of the External Ear - A Comprehensive Information

Introduction:

The ear is an important sensory organ. The external ear is commonly known as the auricle or the external auditory canal. This organ is composed of cartilage, skin, and other appendages. The cartilage and skin are similar to the tissues in other parts of the body. Many conditions are responsible for inflammation and diseased conditions of the external auricle. This inflammation can occur due to infectious, immunological, and traumatic causes.

What Are Common Diseases of the External Ear?

The outer ear's main function is to transmit sound, and this function gets impaired when the ear canal is filled with earwax, infected material, or tumor. This can interfere with sound reaching the tympanic membrane or the eardrum. The common diseases of the ear are mainly divided into three groups:

1. Injuries and Infections:

• Frostbite- This is a condition where the outer ear, which is exposed the most, is affected by freezing. Wind, the temperature below freezing, duration of exposure, and humidity, can act as a predisposing factor for frostbite. The affected area always begins from the outer edge of the ear. This leads to the ear becoming yellow-white or waxy in appearance, hard and cold on the touch, and numb with loss of skin sensation. Frostbite is managed by placing the affected individual in a warm room, but the frozen ear is kept cool by applying a piece of ice wrapped in a towel so that the blood circulation gradually returns. Ear massage is mostly avoided in such cases. Heat application before the circulation can lead to clotting of blood vessels and death of the ear part. This can eventually lead to a black ear called dry gangrene.

• Perichondritis- Perichondritis is an infection of the outer ear cartilage. It usually occurs from an injury or water in a polluted swimming pool. Pseudomonas Aeruginosa is a main causative organism. This leads to brownish or greenish, foul-smelling discharge from the outer canal. The affected area becomes dusky red, tender, and three times more than the normal thickness. Immediate antibiotic treatment is required to prevent permanent damage.

• Hematoma: Any type of swelling that causes bleeding of the skin and cartilage that produces rounded, smooth, non-tender purplish swelling known as a hematoma. The clotted blood needs to be removed; if left untreated, It can cause permanent scar tissue formation or irregular thickening of the outer ear, called cauliflower ear. This condition is commonly seen in wrestlers and boxers.

• External Otitis- Microorganisms and molds are responsible for outer ear infections. This condition is commonly seen in humid, warm climates and mostly in swimmers. Itching of the ear is the common symptom that makes the outer ear tender, followed by a foul-smelling fluid draining from it. The canals can become clogged by swelling and draining fluid and impair hearing. Avoiding swimming til the infection subsides can help, along with antibiotic and antiseptic ear drops application.

• Furuncle (Boil in the Ear)- The infection that affects the hair follicle of the body is furuncle, and when this occurs in the hair follicle of the outer ear, this leads to a boil in the ear. This mainly occurs due to infection in the ear canal skin. This leads to swelling, tenderness, and pain in the ear canal. It is managed by applying heat applied in the outer ear or an electric pad that helps in drawing the infection. The administration of local antibiotics with systemic antibiotics is used in preventing infection to other hair follicles.

• Erysipelas of the Outer Ear- It is an infection that is caused by streptococcus bacteria. This usually begins in the ear and spreads to the neck and face. This condition is treated with antibiotic therapy.

• Osteoma of the Bony Ear Canal- It is a bony knob that grows on the tympanic membrane. It is mostly not harmful and does not require any treatment. Surgical removal is only indicated if it becomes large enough to clock the ear canal.

• Cyst in the Ear- Cysts in the ear are commonly caused by the gland that is responsible for lubrication in the ear. This occurs if the gland is obstructed by fatty material accumulation, leading to rounded, soft nodules on the skin.

• Leprosy- It is a skin disease that can affect the skin of the outer ear. It is a painless, slowly progressing, thickening condition that leads to tissue distortion. Antibiotics are effective in arresting the progression of the condition.

• Keloid of the Outer Ear- Overgrowth of scar tissue from any injury or skin incision leading to thickened elevation on the scar is a keloid. This is common in dark-skinned individuals. Surgical removal is an option for most cases.

2. Deformities:

• Lop Ear- Excessive protrusion of the ear from the side of the head is a lop ear. It is a frequent and less serious deformity. Surgery can be performed to bring ears back to normal position.

• Absence of Outer Ear- In some congenital conditions, the outer ear is absent. It is a rare condition. Surgical construction of the outer ear of the tympanic membrane can improve hearing and esthetics.

• Atresia- It is a malformation of the canal in the external ear. It occurs mostly on one side and can be partially closed or completely closed.

• Microtia- It is a congenital deformity where the pinna of the ear is abnormally shaped, small, or absent. This can occur either on one side or on both sides.

3. Other Conditions:

• Impacted Ear Wax- Wax is an important aspect of the ear. Overproduction of ear wax leads to accumulation and blockage of the ear canal passage, causing painless impairment of hearing. These large earwax plugs need to be removed with the help of a physician.

• Eczema- Eczema can affect any part of the body, including the outer ear. The topical application of cortisone ointment is applied to relieve symptoms temporarily.

• Cancer of the Outer Ear- Outer ear is mostly exposed to direct sun and is prone to cancer due to harmful sun rays. Cancers of the ear canal are a rare condition.

Conclusion

Diseases of the external ear are mostly less harmful and can be easily cured by medication, surgery, therapy, or hearing aids. Consult a specialist and address the issue as soon as possible. This is an important step and the best way to increase the positive chances of improving hearing and receiving proper treatment.