EXTERNAL EAR, FURUNCULOSIS, OTOMYCOSIS, WAX

1. Dr. AJAY MANICKAM
JR – DEPT OF ENT
RG KAR MEDICAL COLLEGE

2. Congenital
Traumatic
Inflamatory

3.  Bat ear – abnormally
protruding ear.
surgically corrected
after 6 years of age
 Preauricular
appendages
 Preauricular sinus
 Anotia
 Macrotia
 Microtia

4.  Haematoma of the
auricle
 Lacerations /
avulsion of pinna
 Frostbite
 Keloid of the auricle

5.  Perichondritis
 Relapsing polychondritis
 Chondrodermatitis
nodularis chronica helicis

6.  Inflamation of perichondrium
with pus between
perichondrium and cartilage
 Pseudomonas /
staphylococcus aureus
 Burning sensation of ear,
painful movement of the ear
 Fever
 Body ache
 Pinna totally deformed –
cauliflower

7.  Antibiotics based
on C/S
 Local aluminium
acetate
application
 I & D, insertion of
drainage tube
with multiple
openings
 Pressure bandage

8.  Congenital
 Trauma
 Inflamation
 Tumours
 miscellaneous

9.  Congenital
1. Atresia of ear canal
2. Collaural fistula
 Traumatic
1. Lacerations minor &
major

10.  Acute inflamation of skin lining EAC
 2 aetiology
 Infective
1. Bacterial – furuncle / malignant OE
2. Fungal – otomycosis
3. Viral – herpes zoster oticus / OE
haemorrhagica
 Reactive
1. Eczematous
2. Seborrhoeic
3. Neurodermatitis

11.  Fungal infection
affecting external ear
 Diabetes &
immunocompromised
factors – predisposes
 MC- Aspergillus niger
(black headed)–
 others – candida
albicans (white),
aspergillus fumigatus
(green/brown)

12.  Irritation
 Pain
 Deafness
 Itching
 Discharge sometimes
 Ear swab – C/S, blood
sugar estimation

13.  Thorough cleaning –
syringing/ suction
 Painting with 2%
salicylic acid
 Anti fungal drops eg –
nystatin
 Keep ear dry
 Treatment of
underlying disease
(diabetes)

14.  Inflamation of hair follicles –
staphylococcus aureus -
pseudomonas & proteus
 May spread subcutaneously
– cause cellulitis
 Etiology - Scratching ear
canal , allergy ,
immunocompromised
patients, diabetes ,
depression

15.  Pain
 Deafness
 Discharge – purulent
 Tenderness on moving
pinna or pressing
tragus
 Treatment
1. 10% icthymol glycerin
paint – 2 to 3 times
2. Antibiotics ,
analgesics
3. Prevent recurrence

16.  Pseudomonas infection
 Diabetics /
immunosuppresed
 Facial nerve
involvement is common
 May involve skull base,
jugular foramen
 CT scan – to know its
extent

17.  IV antibiotics –
tobramycin, ticarcillin,
3rd gen cephalosporins
6 – 8 weeks
 Control diabetes
 Surgical debridement
of devitalised bone &
tissue to be done
judiciously.

18.  Mixture of ceruminous
and sebaceous gland with
desquamated epithelium
in EAC
 Functions – anti bacterial
action , traps dust and
foreign body
 Causes of excess wax
collections
1. Excess formation
2. Less oily
3. Narrow canal
4. Hot & dry climate
5. Stiff hair in EAC
6. Apprehensive patients

19.  Symptoms
1. Deafness
2. Irritation & itching
3. Otalgia
4. Tinnitus
5. Cough reflex
 Treatment
1. Waxolytic agents
2. Syringing
3. Hooking with hook or
forceps

20.  Non living
 Living
Methods of removal
1. Forceps
2. Syringing
3. Suction
4. Microscopic removal
5. Post aural approach