Desease of external EAR Flashcards
what is Microtia & Anotia?
whsts the clasification & tx
Microtia is an non complet ear & Anotia is the abcens of ear cartilago.
Clasificacation: MARX SYSTEM I-III
Ribs cartilaginous –> 4 steps: Brent technique
whts some complication of Nagata technique for MICROTIA?
Infections
Hematomas formation
Skin-flap necrosis
Scar contracture
Poor contouring
An increase in the distance from the
helical rim to the mastoid is thought to
be due to a lack of the antihelical fold
and prominence of the conchal bowl.
tx: Otoplasty
Complication: Hematoma or excesive retraction of ear
Protuding ears (Prominauris)
These are often associated with
malformations of the pinna and the
structure of the middle ear.
px should not have conduction hearing on that side and mostly have MICROTIA.
Atresia + Stenosis of the external auditory canal (EAC)
hearing loss in atretic
ears is conductive hearing loss of 50-70 db
Male px with Mass or draining tract along anterior
border of sternocleidomastoid muscle
usually near the angle of the mandible.
has ear recurrent infection dreining.
the CT says that is asociate to FACIAL NERVE (7). and infections.
Whats the Dx?
whsts the tx?
DX: First Branquial CLEFT ANOMALIES
TX: ecision &/or draining
- Not Reinfection
whats Connor McGregor coliflower name patology auricular trauma?
whts the Tx?
Shearing
forces secondary to blunt trauma to the
pinna lead to an accumulation of blood in the subperichondrial space.
NECROSIS or further injury or
infection
Tx: incision skin + irrigation ss0.9% others:
cotton
bolsters, plaster molds, silicon putty,
and water-resistant thermoplastic splints.
Thats all Auricular Laseration Tx?
What tipo to sergury + antibiotics must use?
Auricular lacerations should be cleaned
and debrided prior to repair.
Extensive? –> Reconstruction
Uso of quinolonas
Male px went to polonorth then have some Temperature <10 C may lead to:
Hypoesthesia , Ear pale and the cyanotic, ear thaws pain ,erythema and bleeding
wthts dx & tx? for bleeding, pain and cold
Auricular Frosbite
1°: rewarming of the ear to 40°C to 42°C.
& Pain killer + antibiotics + vasodilators
whats the clasififcation of AURICULAR BURNS
and Tx?
grado de lesion + sintomas.
1 grade: Epidermis erytema + pain.
2 gradeNot into Dermis, Painblister + thickness(sensibilidad).
3 grade: subdermis/hipodermis looks grey/black painblister.
4grade: subcutaneos, muscule or nerve, bone cartilaginous… & grey/black ecara.
Tx: silver sulfadiazine for 1grade
Others:
Femele px has alergy at hands and neck, fh of asma… etc, Lesions presenting on the ear are often
pruritic and erythematous.
candida second infection…
whats the dx and tx?
and whats the first coplication?
Atopic Dermatitis
F
Emolients
topicl steroids
antihistaminics
Complication: Bacterial injury. –>Use Topic Anitbiotics
Famele px currently with indurated,
erythematous, pruritic, and poorly
demarcated process. In contrast,
irritant dermatitis often presents with
welldefined areas of exposure, using jelery earing
Contac Dermatitis
Steroids + Emolients + Antihistaminics + avoiding
Famele px come with erythematous papules
oval salmonpink plaques with silvery
white scales found on the elbows, knees,
scalp, and buttocks
whats dx, tx and patogenesis factor?
Dx: Psoriasis
Tx: hydrocortisone (Head) | Retinoids + calcineurin inhibitors, for sistemic or severe psoriasis.
Patogenesis: Th1 +Th17 sobreeaction skine hiperinflamation
whats th complication of an FOREIGN BODIES on the external auditory conduct?
EAC Complication
Granulomatous tissue:
se ve eritroedematizado.
#Es por no haber retirado a tiempo un cuerpo extraño del conducto auditivo y genera tejido granulomatoso
Male 35yo px with persisten SINUSITIS has acute earpian + hearing loss and has NO Otorrea, at both ears (Bilateral) has no other sintoms (Bony)…
whats the dx and the tx?
Dx: Keratosis Obturands (Acumulation of descamed debris has no bone damage)
Tx: remove & cleaning or
canalplasty –>¿Reccurent?
Male 70yo px with Otorrea dull/chronic pain, has NO hearing loss, at ear exploration (Unilateral) has BONE EROSION,and focal ulceration. pathology will demonstrate squamous tissue.
whats the dx, tx
Dx: Cholesteatoma (Acumulation of descamed debris has bone damage)
Tx: sucting + debriding + topic antibiotic.
if there is necrotic bone and potentially tympanomastoidectomy or canal wall
down mastoidectomy
is the must commun neoplasia at auricula:
old px with hystoty excesive SUN esposure…
has Skin lesion : nodular, ulcerated, and/or bleeding. Helix and in the preauricular area due to sun exposure.
dx and tx
DX: Basal Cell Carcinoma or de EE
Tx: 5F Imiquumod + Electrodesication.
Nonsurgical: Photodynamic therapy,
topical 5-fluorouracil, imiquimod, radiation
therapy, vismodegib
Surgical therapies: Curettage with
electrodessication, Cryosurgery, wide local
excision and Mohs micrographic surgery
(MMS).
Elderly male present plaques, noduls and ULCERATIONS, Auricular lesions occur on the helix
or preauricular region May occur on any sun-exposed areas.
dx & tx
Tx depends on de stage/grade
t1 Only External Auditory Conduction
t2 EAC + Bone Erosion
t3 - t2 + Tickness + Facial Paralsis
t4 have more that acustic sistem and arround.
Dx: CUTANEOUS SQUAMOUS CELL CARCINOMA
tx: topical 5-fluorouracil
Syrgical- electrodessication
1 grade: Sleeve excision
2 grade: Lateral temporal bone resection
3 & 4 grade: Subtotal temporal bone
resection
Glandular Tumors:
Characterized by subepithelial proliferation of glandular structures
with nests of myoepithelial components in a chondromyxoid
stroma.
Pleomorfic ADENOMA
Glandular Tumors:
characterized by double-layered cuboidal or columnar cells epithelium may show apical “snouts” of apocrine secretion, indicative of ceruminous gland origin.
These are often reddish, polypoid, painless masses that may grow undetected for prolonged periods of time.
Patients may present with a conductive hearing loss or otitis externa.
Are thought to arise from the ceruminous apocrine glands of the EAC
Ceruminous Adenoma
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glandular Tumors:
Most often found in salivary gland tissue.
Suspected to arise from eccrine sweat glands or ectopic salivary
glands.
Predilection for perineural, perivascular, and fatty infiltration.
These tumors may show cribriform, tubular, or solid patterns of
cellular arrangement.
ADENOID Cystic Carcinoma
