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Otitis Externa
Published in Firza Alexander Gronthoud, Practical Clinical Microbiology and Infectious Diseases, 2020
The aetiology of AOE is multifactorial. Regular cleaning of the ear canal removes cerumen, which is an important barrier to moisture and infection. Cerumen creates a slightly acidic pH that inhibits infection (especially by P. aeruginosa) but can be altered by water exposure, aggressive cleaning, soapy deposits, or alkaline eardrops. Debris from dermatologic conditions may also predispose to infections. Other factors such as sweating, allergy and stress have also been implicated in the pathogenesis of AOE. AOE is more common in regions with warmer climates, increased humidity or increased water exposure from swimming.
Alkaptonuria
Published in William L. Nyhan, Georg F. Hoffmann, Aida I. Al-Aqeel, Bruce A. Barshop, Atlas of Inherited Metabolic Diseases, 2020
William L. Nyhan, Georg F. Hoffmann, Aida I. Al-Aqeel, Bruce A. Barshop
Patients with alkaptonuria have no symptoms as children or young adults. With age, they develop pigmentation of the sclerae or cartilage of the ear (Figures 14.4, 14.5). The condition of widespread deposition of pigment in alkaptonuria was first called ochronosis by Virchow [22] because the gray, blue, or black pigment appeared ochre under the microscope. These pigment deposits should be visible by 30 years of-age. Actually, deposition may be widespread throughout the cartilage and fibrous tissue of the body [23–27]. Pigment may be seen at surgery and of course the diagnosis may become apparent first in this way with the rapid formation of pigment on exposure of tissues to air [28]. Pigment may be seen in the buccal mucosa and the nails. Grayish-blue longitudinal pigment was reported [29] on the finger nails, and there was pigment on the tympanic membranes. There may be deposits in the skin (Figures 14.6, 14.7), leading to areas of dusky coloration of the skin. In addition to those shown, the cheeks, forehead, axillae, and genital regions may be involved. The sweat may be dark and the cerumen brown or black.
The Special Sense Organs and Their Disorders
Published in Walter F. Stanaszek, Mary J. Stanaszek, Robert J. Holt, Steven Strauss, Understanding Medical Terms, 2020
Walter F. Stanaszek, Mary J. Stanaszek, Robert J. Holt, Steven Strauss
Problems with any of the structures involved in sound transmission from the body surface to the brain may impair hearing. External otitis is an inflammation of the outer ear and may block the progress of sound waves. Impacted cerumen is an accumulation of cerumen or earwax that blocks the ear canal and prevents sound waves from reaching the tympanic membrane. Inflammation of the tympanic membrane is known as myringitis or tympanitis and may prevent the tympanic membrane from vibrating appropriately. Eustachian tube dysfunction is a general term used to describe any condition in which the ability of the eustachian tube to equilibrate ambient and middle ear pressure is impeded.
A novel approach to a recalcitrant case of psoriatic otitis externa
Published in Acta Oto-Laryngologica Case Reports, 2023
N. J. McInerney, M. Riglar, P. Casserly
Otitis externa is a frequently encountered pathology by otorhinolaryngologists, with its incidence reported as 1% [1]. It is an acute inflammation of the external auditory canal, due to bacterial, fungal or non-infectious causes. Non-infectious causes can include psoriasis and atopic dermatitis. The ear has a number of inherent defense mechanisms to prevent against infection. Firstly, the tragus and anti-tragus provide a barrier to prevent macroscopic structures entering the canal. Cerumen within the external auditory canal creates an acidic environment which inhibits micro-organism growth. Alterations in canal epidermis can cause pruritus, and frequent itching can alter the skin-cerumen barrier leading to impaired cerumen production and inadequate epithelial migration which precipitates otitis externa.
Temporary threshold shift following ear canal microsuction
Published in International Journal of Audiology, 2020
Cerumen (earwax, or wax) is a natural physiological substance of the ear secreted from the external auditory meatus (EAM, or ear canal), which cleans, protects and lubricates the EAM. Unless the levels become excessive, it forms a coating on the EAM and then migrates using a self-cleaning process that moves the cerumen to the entrance of the meatus, where it is naturally expelled. However, cerumen or other debris in the ear (e.g. shed hairs, dirt, sand, skin and foreign objects) can become excessive and sometimes impacted. Impacted cerumen or debris can cause problems, such as conductive hearing loss, aural fullness, tinnitus and vertigo (Schwartz et al. 2017; Sharp et al. 1990; Subha and Raman 2006). In these circumstances, removal of cerumen/debris is recommended (for the purposes of the current study, cerumen/debris will be referred to as cerumen). Approximately 2.3 million people per year in the UK seek medical treatment for impacted cerumen to alleviate the symptoms (Guest et al. 2004).
Practice patterns of South African audiologists in cerumen management: a pilot study
Published in International Journal of Audiology, 2018
Cerumen is a normal occurring substance in the external auditory meatus, which serves lubrication and antibacterial functions (Armstrong 2009). Cerumen removal in the external auditory meatus occurs through a self-cleaning mechanism entailing epithelial migration, which is also assisted by the jaw movements during mastication (Phanguphangu, 2017). Cerumen impaction can occur when cerumen is produced in large quantities and the migratory mechanism fails to push cerumen to the outer end of the auditory meatus (Saana et al. 2014). Cerumen impaction, and sometimes excessive cerumen, often impedes audiological procedures and thus warrants removal (Johnson et al. 2013).