Outer ear disorders

Diseases of the outer ear refer to various types of inflammation of both the outer ear and the ear canal, as well as chronic non-inflammatory diseases of the auricle, the tip of the ear and the outer ear canal. Diseases involving this part of the ear most often affect the skin, where both infectious and non-infectious changes can take place, both acute and chronic, and of a long-term nature. Sometimes even boils, abscesses or other changes on the skin are formed.

The outer ear consists of the auricle, external ear canal and eardrum. The auricle has a cartilaginous part except for the lobe of the auricle, where the cartilage is not present, while the delicate and soft cartilage of the auricle allows it to rotate flexibly. The external auditory canal, or ear canal or auditory canal, is a tube made up of both bony and cartilaginous parts. In an adult, the ear canal is about 3 cm long and has a self-cleaning ability where it expels debris outwards.

Nevertheless, many diseases are problematic precisely due to blockage of the ear canal by earwax. At the end of the ear canal is the eardrum, which is also the boundary between the outer and middle ear. The tympanic membrane is a fibrous fine membrane 0.1 mm thick, while the healthy colour of the tympanic membrane is greyish and the tympanic membrane is shiny. The sound that a person hears travels through the ear canal and strikes the eardrum, which amplifies the sound signal and passes it on. Possible problems are thus often manifested by hearing impairment.

Abscesses, boils, carbuncles and furuncles

Various skin and subcutaneous formations can form on the outer ear, but also, for example, in its close and proximal surroundings. For example, boils, various inflammatory deposits, suppurating areas with infection and also necrotizing deposits with tissue parts, so-called abscesses. For example, on the auricle or on the tip of the ear, they can arise quite often on the basis of bacterial or other infection, and this infection can originate both from the external environment and directly from within the body.

For example, as a result of inflammation under the perichondrium of the ear, which is the ligamentous covering of the cartilage of the outer part of the ear, deposits can form where subcutaneous inflammation and infection arise from within and these, over time, roll over onto the skin and become visible. In this case, pain and possibly temperature are common, as the disease is inflammatory in nature. In the case of an abscess, there is even a suppurating bed and the disease is thus very uncomfortable for the patient.

Many times these skin diseases of the outer ear cause problems in the inner structures, where the earlobe or the tip of the ear loses important properties of either the subcutaneous tissues, ligaments or cartilage. Usually in the case of such diseases, not only antibiotics need to be administered, but surgical treatment is also necessary, where the subcutaneous and cutaneous deposits are cleared of infection and also the site needs to be checked afterwards to prevent recurrence and return of inflammation.

Also, not only the outer part of the ear, but also, for example, the external ear canal can be attacked by various herpes viruses or mycotic or bacterial infections, and a furuncle or an abscess can form here as well. These conditions are very painful and uncomfortable, the person is more sensitive to touch and, in exceptional cases, the pain can also go to the inner parts of the ear. Also, the subcutaneous tissue around the outer ear can be affected by painful and necrotizing abscess deposits, which also cause swelling of the upper part of the ear.

Cellulitis of the outer ear

The outer ear can also be troubled by cellulitis. However, this is not what many people think of as cellulitis, because it is a bacterial disease that affects the skin, most often of the ear and earlobe, less often of the ear canal. As a result of the infection, the skin is painful, reddened, there is also sometimes minor swelling and swelling, the affected area is warm to the touch and sometimes the pain can radiate to the inside of the ear.

It is very important in the differential diagnosis to differentiate cellulitis from other dermatitis and inflammation that may occur on the ear. As it is a bacterial disease of the external ear, most commonly caused by streptococci and staphylococci, high doses of antibiotics are usually used for treatment, most commonly penicillinia, to which the bacteria do not have such high resistance. In addition, painkillers and high temperature drugs are also used.

After the disease has subsided, it is necessary to clean the ear for thorough healing, but very carefully, so as not to irritate the skin, which can be one of the main risk factors for recurrence and return of this infection. Auricular cellulitis is one of the inflammatory diseases of the outer ear, but it can sometimes spread to the outside of the ear. In any case, it is not a serious and overly widespread disease, and symptomatic treatment of the skin after control of the infectious inflammation of the disease is important.

Inflammations of the outer ear

The most common diseases of the outer ear are various inflammations. It can be malignant otitis externa, classical infectious otitis externa and ear canal, cholesteatoma of the otitis externa, but also acute otitis externa chemical, contact, actinic, eczematous and reactive, which already belong to the inflammation caused not by infection, but for each type of inflammation by a different external and external factor. But each such inflammation must be treated consistently, otherwise it will pass into a chronic form.

The most common is the classic infectious and non-infectious otitis (inflammation of the ear). In the case of infectious inflammation, it is most often caused by staphylococci, streptococci and various viruses, herpes viruses or yeasts, while in the case of non-infectious inflammation, it is usually caused by an excess of earwax, but this type of inflammation of the ear canal and outer ear soon becomes infectious, but this infection arises only secondarily.

Most often it is an acute form of inflammation, but if left untreated for a long time, it can become chronic. There are also several types of otitis externa, such as circumscribed otitis, otitis cartilaginousis, diffuse otitis externa or mycotic otitis. The acute form of inflammation is manifested by pain and swelling, while in chronic inflammation there is itching and atrophy of the skin, but the ear canal and the external ear are no longer swollen.

The most common treatment for common inflammation is topical treatment, depending on the causative agent of the inflammation, either antibacterial, antiviral or antifungal, either in the form of a solution and an ear rinse, or in the form of ointments, and in the case of antivirals, also in the classical medical form. It is also important to clean and disinfect the ear, even multiple times every day or every other day in the case of severe inflammation. In some bacterial infections, puncturing the eardrum, called paracentesis, is also helpful.

In order to prevent acute inflammation from becoming chronic, it is necessary for the patient to see a doctor as soon as possible after the onset of symptoms and to ensure that the diagnosis is correct and the treatment is adequate to the origin of the disease. In addition, in these cases, sufficient time is necessary for healing and subsequent checks of the ear canal and ear, and, if necessary, a swab is also performed to determine exactly whether there is the presence of microorganisms on the skin. Inconsistent treatment will cause a recurrence or even a chronic occurrence.

Inflammatory diseases involving the external ear include malignant inflammation and also cholesteatoma of the external ear. This is a smaller cyst that may resemble a tumor in its behavior, but it is not a tumor. This disease most often affects children and newborns and is the result of inflammation, acute or chronic, even with suppuration. Sometimes it can even penetrate into the middle ear. Treatment is only surgical, when it is necessary to remove this cyst.

Other disorders affecting the ear and the earlobe

Other diseases that affect the outer ear, specifically the outer part of the ear, i.e. the auricle and the lobe, include, for example, perichondritis of the outer ear, chronic nodular chondrodermatitis of the helix, or various deformities of the auricle or the tip. The auricle may also be affected by eczematous disease, or rosea or cartilage inflammation of the auricle, which, although of an inflammatory type, arises from injury, frostbite or burn to the auricle and is not a classical inflammation.

This inflammation is technically called perichondritis and affects both the auricle and the lobe of the ear. It is a very unpleasant disease where there is redness and swelling of the whole ear and auricle, high fever, painful and warm ear. Sometimes it even happens that the cartilage dies and deformity of the auricle occurs. The treatment is antibiotic, but many times surgical treatment is necessary, especially if abscesses occur as a complication, where drainage must be performed.

Eczema of the auricle is usually triggered by chemicals or allergens, sometimes also by microorganisms, but most often eczema arises as a result of irritant action of soaps or shampoos. This ear disease has two forms namely dry or moist. In some cases, there may also be purulent blisters that burst or painful cracks on the skin. Treatment is usually by removing the cause of the eczema and administering corticosteroid ointments.

The outer ear itself, whether the auricle or the lobe, can also be affected by the so-called rose. This skin disease also affects the surrounding area of the ear and can also spread to the ear canal. Rosacea is a disease caused by streptococcus and the affected part of the skin is deep red and clearly demarcated from the rest of the skin. The disease is particularly unpleasant because of its painfulness, not only to the touch but also at rest. Due to the nature of the disease, treatment is conservative with antibiotics.

Other ear canal disorders

In addition to various skin and inflammatory diseases, the ear canal also develops various deformities, such as outer ear canal flapping or, even worse, outer ear canal exostosis, which is a process in which the bone thickens at the front and back of the ear canal wall. At the same time, white neoplasms and bony effusions form, which disrupt the healthy shape of the ear canal, cause hearing problems and pain, and must be addressed surgically.

Very often, a sebaceous plug is also formed in the ear canal. This condition is known professionally as hardened earwax and is an excessive accumulation of earwax and hardening of the ear, which is manifested by clogging in the ear and impaired hearing. The problematic cause of this condition is overproduction of sebum from the sebaceous glands, or improper cleaning or imperfect hygiene. In this case, however, the solution is simple and consists in flushing the ear canal.