Hostname: page-component-8448b6f56d-c4f8m Total loading time: 0 Render date: 2024-04-19T05:10:11.353Z Has data issue: false hasContentIssue false
  • English
  • Français

Surgical management of external auditory canal lesions

Published online by Cambridge University Press:  28 January 2013

P M Spielmann ,
S McKean ,
R D White  and
S S M Hussain
P M Spielmann
Affiliation:
Department of Otolaryngology, Ninewells Hospital and Medical School, Dundee, Scotland, UK
S McKean
Affiliation:
Department of Otolaryngology, Ninewells Hospital and Medical School, Dundee, Scotland, UK
R D White
Affiliation:
Department of Radiology, Ninewells Hospital and Medical School, Dundee, Scotland, UK
S S M Hussain*
Affiliation:
Department of Otolaryngology, Ninewells Hospital and Medical School, Dundee, Scotland, UK
*
Address for correspondence: Mr S S Musheer Hussain, Consultant Otologist and Neurologist, Department of Otolaryngology, Ninewells Hospital and Medical School, Dundee DD1 9SY, Scotland, UK Fax: +44 (0)1382 632816 E-mail: musheer.hussain@nhs.net
Get access Rights & Permissions [Opens in a new window]

Abstract

Background:

Lesions arising in the external auditory canal that require surgical excision are uncommon. They are associated with a range of pathologies, including bony abnormalities, infections, benign and malignant neoplasms, and epithelial disorders.

Methods:

This paper describes a 10-year personal case series of external auditory canal lesions with chart, imaging and histopathology review.

Results:

In total, 48 lesions required surgical management, consisting of: 13 bony lesions; 14 infective lesions; 14 neoplasms with 11 histological types (including ceruminous adenoma and the extremely rare cavernous haemangioma); 3 epithelial abnormalities; and 4 other benign lesions. The surgical management is described.

Conclusion:

This study emphasises the diagnostic differences between exostoses and osteomas, and between external auditory canal cholesteatoma and keratosis obturans. It also discusses the management of aural polyps, and highlights the need to excise external auditory canal masses for histology in order to guide subsequent treatment.

Keywords

External Auditory CanalOuter EarEar DiseasesEar Neoplasms
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 127 , Issue 3 , March 2013 , pp. 246 - 251
Copyright
Copyright © JLO (1984) Limited 2013

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1Hospital episode statistics. In: http://www.hesonline.nhs.uk [6 January 2012]Google Scholar
2Chaplin, J, Stewart, IA. The prevalence of exostoses in the external auditory meatus of surfers. Clin Otolaryngol 1998;23:326–30CrossRefGoogle ScholarPubMed
3Robinson, PJ. Exostosis of the external auditory canal. In: Gleeson, M, ed. Scott-Brown's Otorhinolaryngology, Head and Neck Surgery, 7th edn.London: Hodder Arnold, 2008;3367–9Google Scholar
4Umeda, Y, Nakajima, M, Yoshiola, H. Surfer's ear in Japan. Laryngoscope 1989;99:639–41CrossRefGoogle ScholarPubMed
5Michaels, L. Ear and temporal bone. In: Cardesa, A, Slootwig, PJ, eds. Pathology of the Head & Neck. Heidelberg: Springer, 2006;234–60Google Scholar
6Babiatzki, A, Sade, J. Malignant external otitis. J Laryngol Otol 1987;101:205–10CrossRefGoogle ScholarPubMed
7Gordon, G, Giddings, NA. Invasive otitis externa due to Aspergillus species: case report and review. Clin Infect Dis 1994;19:866–70CrossRefGoogle ScholarPubMed
8Gehanno, P. Ciprofloxacin in the treatment of malignant external otitis. Chemotherapy 1994;40:35–40CrossRefGoogle ScholarPubMed
9Bernstein, JM, Holland, NJ, Porter, GC, Maw, AR. Resistance of pseudomonas to ciprofloxacin: implications for the treatment of malignant otitis externa. J Laryngol Otol 2007;121:118–23CrossRefGoogle ScholarPubMed
10Shupak, A, Greenburg, E, Hardoff, R, Gordon, C, Melamed, Y, Meyer, WS. Hyperbaric oxygenation for necrotizing (malignant) otitis externa. Arch Otolaryngol Head Neck Surg 1989;115:1470–5CrossRefGoogle ScholarPubMed
11Phillips, JS, Jones, SEM. Hyperbaric oxygen as an adjuvant treatment for malignant otitis externa. Cochrane Database Syst Rev 2005;(2):CD004617CrossRefGoogle ScholarPubMed
12Tay, HL, Hussain, SSM. The management of aural polyps. J Laryngol Otol 1997;111:212–14CrossRefGoogle ScholarPubMed
13Loh, LE. How benign are aural polyps? Singapore Med J 1987;28:249–50Google ScholarPubMed
14Dawes, PJ, Soames, JV. The inflammatory aural polyp: a predictor of cholesteatoma in children? Aust J Otolaryngol 1995;2:31–3Google Scholar
15Hussain, SSM. Conservative treatment in the management of inflammatory aural polyp. J Laryngol Otol 1992;106:313–15CrossRefGoogle ScholarPubMed
16Thompson, LDR, Nelson, BL, Barnes, EL. Ceruminous adenomas. Am J Surg Pathol 2004;28:308–18CrossRefGoogle ScholarPubMed
17Covelli, E, De Seta, E, Zardo, F, De Seta, D, Filipo, R. Cavernous haemangioma of external ear canal. J Laryngol Otol 2008;122:e19CrossRefGoogle ScholarPubMed
18Miah, MS, Crawford, S, White, S, Hussain, SSM. Tumors of the Ear and Cranial Base: Malignant transformation from benign papillomatosis of the external auditory canal. Otol Neurotol 2012;33:643–47CrossRefGoogle Scholar
19Shire, JR, Donegan, JO. Cholesteatoma of the external auditory canal and keratosis obturans. Am J Otol 1986;7:361–4Google ScholarPubMed
20Anthony, PF, Anthony, WP. Surgical treatment of external auditory canal cholesteatoma. Laryngoscope 1982;92:70–5CrossRefGoogle ScholarPubMed
21Dubach, P, Mantokoudis, G, Caversaccio, M. Ear canal cholesteatoma: meta-analysis of clinical characteristics with update on classification, staging and treatment. Curr Opin Otolaryngol Head Neck Surg 2010;18:369–76CrossRefGoogle ScholarPubMed
22Persaud, RAP, Hajioff, D, Thevasagayam, MS, Wareing, MJ, Wright, A. Keratosis obturans and external ear canal cholesteatoma: how and why we should distinguish between these conditions. Clin Otolaryngol 2004;29:577–81CrossRefGoogle ScholarPubMed
23Piepergerdes, MC, Kramer, BM, Behnke, EE. Keratosis obturans and external auditory canal cholesteatoma. Laryngoscope 1980;90:383–91CrossRefGoogle ScholarPubMed
24Hickey, SA, Scott, GA, Traub, P. Defects of the first branchial cleft. J Laryngol Otol 1994;108:240–3CrossRefGoogle ScholarPubMed
25Corbridge, RJ, Michaels, L, Wright, A. Epithelial migration in keratosis obturans. Am J Otolaryngol 1996;17:411–14CrossRefGoogle ScholarPubMed
26Naiberg, J, Berger, G, Hawke, M. The pathologic features of keratosis obturans and cholesteatoma of the external auditory canal. Arch Otolaryngol 1984;110:690–3CrossRefGoogle ScholarPubMed
27Dubach, P, Hausler, R. External auditory canal cholesteatoma: reassessment of and amendments to its categorization, pathogenesis, and treatment in 34 patients. Otol Neurotol 2008;29:941–8CrossRefGoogle ScholarPubMed
28Paparella, MM, Goycoolea, MV. Canalplasty for chronic intractable external otitis and keratosis obturans. Otolaryngol Head Neck Surg 1981;89:440–3CrossRefGoogle ScholarPubMed