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Posts Tagged ‘Atresia’

Those funny looking flaps on the side of your head are more than an accessory piece for holding earrings or holding your eye glasses in place. Those flaps are referred to as the outer ear, also known as the auricle or pinna, and are a vital role in the hearing process. The outer ear picks up sound and then funnels it down the ear canal. The next time a friend calls your name from across the room remember to thank your pinna for recognizing the sound.

The outer ear can suffer from a multitude of disorders. It is a site for trauma, impacted cerumen, and foreign bodies. It is commonly subjected to inflammation. Malformations of the outer ear are prevalent, which can lead to hearing problems. The good news is most of these disorders are manageable and treatable.

Anatomy of the Outer Ear:

  • Helix: fold surrounding the auricle.
  • Scapha: hollow at the end of the helix.
  • Concha: deep fossa of the external ear.
  • External Auditory Meatus: mouth of the canal of the temporal bone that carries sounds to the eardrum.
  • Tragus: prominence over and in front of the acoustic meatus.
  • Lobe: fleshy part at the base of the ear.
  • Navicular Fossa: boat-shaped fold of the ear.
  • Antihelix: curved ridge in front of the helix.

Impacted Cerumen:

Cerumen is a waxy substance found in the ear, that functions to lubricate, clean, and protect the ear. Impacted cerumen is an accumulation of wax in the ear canal that interferes with the flow of sound to the eardrum often causing itching and ear pain. Impacted cerumen occurs naturally in some patients. It is also the fate of many Q-tip-wielding patients who inadvertently pack cerumen farther back into the ear canal in an ironic attempt to clean their ears. To treat impacted cerumen one must remove the excessive cerumen with treatment by a doctor or audiologists.

Inflammatory Disorders:

1. Acute External Otits (swimmer’s ear):

  • Diffuse bacterial infection of the ear canal
  • The presence of germs that can infect the skin and an impairment in the skin of the ear canal that allow infection can lead to Acute External Otitis
  • Known as an ‘earache’
  • Occurs rapidly and worsens quickly
  • Symptoms: pain, itching, pressure, and hearing loss
  • Ear canal is red and swollen, and simply touching the outer ear causes pain
  • The combination of wax in the ear canal and swelling of the skin occlude the canal to block sound from entering the eardrum, causing a temporary conductive hearing loss
  • Causes: swimming in polluted water, water trapped in the ear canal after a shower
  • Treatment: antibiotic ear drops and avoidance of water; oral antibiotics given in severe of resistant cases
  • Prevention: the use of ear plugs when swimming, avoid polluted water, avoid inserting (cotton swabs) into the ear canal

Congenital Malformations:

1. Microtia:

  • Deformity present at birth where the pinna/auricle is small, abnormally-shaped or absent
  • Divided into four separate division:
  1. Anotia: no ear, most severe
  2. Grade 1 Micortia: the ear is smaller than normal and most of the features of a normal ear present
  3. Grade 2 Microtia: missing normal features of the ear
  4. Grade 3 Microtia: the ear has a vertical skin appendage with a malformed lobule of the lower end
  • Can be unilateral (90%) or bilateral; in unilateral cases the right ear is more commonly affected
  • More common in males
  • Generally occurs in isolation but associated with Treacher-Collins Syndrome
  • Occurs in every 1 out of 8,000- 10,000 births
  • A conductive hearing loss is associated with microtia, caused by an inefficient conduction of sound to the inner ear
  • Negative psychological effects
  • Normal intelligence
  • Treatment: Reconstructive surgery can be preformed to construct a normal outer ear, generally recommended after the age six. Conventional hearing aids and bone anchored hearing aids may be needed for improving one’s hearing.
  • Celebrities with Microtia: Paul Stanely of KISS,

In the same way, I may not hear music the way other people hear it, but I have nothing else to compare it to, or didn’t for most of my life. I haven’t felt at a loss for anything. I have no sense of the direction of sound, yet I have no trouble mixing a stereo album. I hear the expanse or width of sound but I can’t necessarily tell you where it’s coming from.

2. Atresia:

  • Closure of the external auditory canal
  • Unilateral about 70%
  • Males about 60%
  • Right Ear about 57%
  • Conductive hearing loss
  • Often accompanied by microtia and proportional middle ear malformations
  • Normal intelligence
  • Treatment: Must begin with early identification and discussion of the development and education issues specific to the child. If the hearing is affected, surgery can open the ear canals.  Cosmetic surgery can be performed to create a normal looking ear. Cosmetic surgery is usually done when a child’s face  is completely grown. The age varies from child to child and is done with consultation of a plastic surgeon. Placement of hearing aids is necessary for normal language development of the child.
  • For more information visit: http://emedicine.medscape.com/article/878218-overview

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