OF EXTERNAL EAR外耳疾病课件.ppt

Auricular injury  Simple: - cleansing with antiseptic solutions - conservative debridement - cosmetic - antibiotics Awareness : contaminated or extensive wounds 5 ?.?. 52 * Foreign Bodies of EAC  Insects. immobilize ; natural oil topical 2% lidocaine remove with instruments Materials: remove with instruments Instruments Otoscope vs Microscope alligator forceps, right-angle hook, suction, etc Topical otic antibiotics if localized reaction Local anesthesia or General anesthesia Cysts  Sebaceous cysts : hair follicles. discrete, mobile mass secondary infected Treatment : complete excision. Pre-auricular cyst and fistula faulty fusion of mesodermal hillocks. fistula opening in front of the incisura. recurrent infection Treatment : complete excision (injection of methylene blue for identification) Keloids -hypertrophy of connective tissue in traumatized areas. -Most common area: ear lobule Treatment : corticosteroid intralesion complete excision (large size) 5 ?.?. 52 * Squamous Cell Carcinoma - most common : ulceration, granulation - s/s : otalgia, otorrhea, headache - DDx : malignant otitis externa - Treatment : wide surgical excision postoperative radiation therapy Middle Ear Otosclerosis Definition: - primary bone dyscrasia - Involvement of oval window results in footplate fixation and persistent conductive hearing loss Abnormal bony overgrowth Symptoms : Conductive Hearing loss ; gradual onset , slow progress If lesion involve cochlear may mixed HL or SNHL Bilateral Otosclerosis 70% No previous infection or trauma Age 20 yr, Most common 30-40 yr Autosomal dominant Female:Male=2:1 Signs : Usually normal examination. normal tympanic membrane. Schwartzes sign: red discoloration under drum - active focus on promontory Weber lateralizes to involved ear Invest