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The External Ear
Published in Raymond W Clarke, Diseases of the Ear, Nose & Throat in Children, 2023
The external ear includes the pinna and the external ear canal. The pinna and the outer part of the ear canal are made of cartilage, covered by perichondrium and skin. A series of ‘hillocks’ derived from the first two branchial (pharyngeal) arches fuse to become the external ear, and developmental abnormalities are fairly common.
Otitis Externa/Swimmer's Ear
Published in Charles Theisler, Adjuvant Medical Care, 2023
Acute diffuse otitis externa is inflammation of the external ear canal. Typically, only one ear is affected, and it can last up to three weeks. Symptoms may include pain, itchiness, drainage of liquid or pus, and temporary hearing loss. Most cases are caused by bacterial (gram negative rods) infection. Such infections are common especially in the summertime and associated with water activities. Moisture provides an ideal environment for bacterial growth. With treatment, symptoms usually clear up in a few days. Necrotizing otitis externa is a life-threatening complication of otitis externa especially in elderly patients with diabetes.1
Dermatitides
Published in Ayşe Serap Karadağ, Lawrence Charles Parish, Jordan V. Wang, Roxburgh's Common Skin Diseases, 2022
Allison Perz, Tara Jennings, Robert Duffy, Warren Heymann
Clinical picture: Otitis externa typically presents with exquisite pain, edema, and erythema of the outer ear. If the etiology is infectious, then warmth, exudate, and discharge may be present. A variation of otitis externa is infectious eczematoid dermatitis, where the external ear oozes with crusting and becomes tender.
Functional results with active middle ear implant or semi-implantable bone conduction device in patients with comparable hearing loss
Published in International Journal of Audiology, 2022
Jennifer L. Spiegel, Bernhard G. Weiss, Mattis Bertlich, Ivelina Stoycheva, Martin Canis, Friedrich Ihler
Indications for implanting an AMEI or a SIBCD show an overlap when it comes to patients with CHL or MHL. Especially those patients, in which acoustic hearing aids are not sufficient, or cannot be worn due to skin problems, recurrent or chronic otitis externa, external ear aplasia, or extraordinarily narrow ear canals benefit profoundly from a bone conduction hearing device. The AMEI offers a broader audiometric range of indication up to 65 dB in comparison to 45 dB in the SIBCD (Sprinzl et al. 2013). However, in particular, in patients with an air conduction threshold up to 45 dB, the choice for the device seems challenging and often needs profound preoperative audiometric investigation, counselling, and education of the patient. The results of our study show that the post-operative performance of patients provided with an AMEI or a SIBCD is similar. Nevertheless, the AMEI has one advantage: cross hearing of the contralateral ear is avoided due to direct stimulation via either remaining ossicles or the round or oval window. In patients with stimulation with a SIBCD, a cross hearing is expected due to the limited transcranial attenuation of bone-conducted sound (Stenfelt 2012). Also, in our investigated cohort a stimulation of the contralateral ear of the SIBCD patient can neither be excluded nor evaluated. Before implantation with an AMEI or SIBCD, extensive counselling and evaluation of potential interference of hearing with a bone conduction device are crucial.
Application of a novel transcanal keyhole technique in endoscopic cholesteatoma surgery
Published in Acta Oto-Laryngologica, 2021
Zhaohui Hou, Fangyuan Wang, Wenjing Zuo, Ya Liu, Wenjia Wang, Kun Hou, Jianping Jia, Shiming Yang
The keyhole technique in the endoscopic management of middle ear cholesteatoma has the following advantages: (1) It is an easy and safe way to inspect and operate on routine cholesteatoma case. The keyhole is quick to be located, and the technique is easy to be learnt. (2) In the initial stage of operation, the keyhole technique can accurately identify the structures and compartments of the middle ear affected by lesions, enabling surgeons to flexibly and timely correct the surgical plans made on the basis of preoperative CT scan information, which shortens the operation time. (3) It can avoid several bony defects being left in the external ear canal caused by the exploration of the endoscopic epitympanic approach and can maximize the preservation of the scutum structure. (4) The application of endoscopic keyhole technique can avoid unnecessary mastoidectomy. In microscopic approach, there are high likelihoods of unnecessary mastoid opening whichever surgical strategy you may choose. Although different materials and various reconstruction methods are available, the natural physiological and anatomical status of the ear canal is still difficult to restore. (5) Second-look procedures using keyhole technique can be applied in endoscopic cholesteatoma management. These procedures require an incision to be made in the ear canal under local anesthesia. Thereafter, the keyhole is exposed, and appropriate endoscopes are reached inside for observation. Subsequently, surgical interventions are carried out. (6) The results of lesions in surgical exploration are intuitive and accurate compared with perioperative non-EPI DWI.
EAS-Combined electric and acoustic stimulation
Published in Acta Oto-Laryngologica, 2021
Anandhan Dhanasingh, Ingeborg Hochmair
In 2005 November, as the world’s first hearing implant company to combine HA with CI audio processor, MED-EL introduced DUET™audio processor in order to overcome all the practical issues with having two separate devices as mentioned above (Figure 14). The DUET™ audio processor featured a single microphone for the TEMPO + audio processor (using the continuous interleaved sampling (CIS+) strategy) and a two-channel HA, allowing 40 dB gain through 1,800Hz in one unit. The ear received the acoustic amplification through the ear mould positioned inside the external ear canal, receives an acoustic amplification from the processor. The processor unit controls both the HA and the CI speech processor, which is powered by a single battery pack. The DUET™ system was designed to amplify acoustic hearing between 125–1,500Hz and between 30–75dB.