Ear Surgeries

Ear Surgeries

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BRAIN ABSCESS DUE TO EAR INFECTION

BRAIN ABSCESS DUE TO EAR INFECTIONMiddle ear is separated fom brain by a very thin plate of bone .Infection can erode this plate. Initially there is generalised inflammation. Later infection is localized to form an abscess. High index of suspicion is necessary to diagnose this condition. Patient becomes gravely ill with high fever,headache, altered level of consciousness , vomiting and fits.CT scan is ordered as soon as possible. Neurosurgeon will drain the abscess through a hole in the scull cap. Strong intravenous antibiotics are given along with anti epileptic drugs.

BATTLE SIGN

BATTLE SIGNBattle's Sign is extreme tenderness and discolouration behind the ear in the area of the mastoid process of the skull, and is an acute sign of basilar skull fracture with local bleeding. Anyone with a history of very recent head trauma with this sign should be sent to the hospital for an immediate CT scan. Named after Dr. William Henry Battle, an English surgeon.

ACCESSORY EAR

ACCESSORY EARAccessory auricles - these look like skin tags and occur adjacent to a normally placed pinna.Sometimes there is cartilage within the tag.This can be removed by surgery. The nerve of muscles of facial expression (7th cranial nerve) is situated closer to the deep attachment of the accessory ear cartilage.If the surgeon does not keep this in mind, this nerve can get damaged during avulsion of the cartilage.

AURICULAR ABSCESS

AURICULAR ABSCESS. "High" piercing, which requires puncture through the cartilage of the upper two third of the pinna may cause auricular perichondritis and abscess formation. Loss of cartilage due to poor blood supply results in an unsightly deformity known as "cauliflower ear," which has a poor chance of good reconstruction. the usual infective agent in auricular perichondritis is a bacterium called Pseudomonas aeruginosa. In the early phase of infection, treatment should focus on eradicating this bacteuium.

PERICHONDRITIS

PERICHONDRITISThis picture depicts a discoloured ear due to infection of the underlying cartilage following unheigenic high ear piercing. Our outer ear is made up of cartilage. Cartilage does not contain blood vessels. It takes nutrition from the thin outer membrane called the perichondrium. When there is a infection of perichondrium, there is a risk of cartilage being deprived of nutrition resulting in cartilage damage. This may lead to a deformed ear known as "cauliflower ear," which has a poor chance of good reconstruction.

EXAMINATION OF THE EAR UNDER THE MICROSCOPE (EUM)

EXAMINATION OF THE EAR UNDER THE MICROSCOPE  (EUM)

Outer and middle ear conditions cannot be diagnosed without examination under magnification. Otoscope gives a magnfication of four.  The ear microscope gives a higher magnification and more freedum to the doctor to use suction and other instruments in the ear.

This is not a painful procedure. Therefore can be done as an out patient procedure.

When there is discharge in the ear, suction helps to visualize the drum.

Before we plan any ear surgeries, EUM has to be done.

Foreign bodies in the ear are better removed under the microscope.

EAR LOBE SEPSIS

EAR LOBE SEPSIS

Ear lobe sepsis after ear piercing can lead to scar tissue formation.

This picture depicts a large keloid of ear lobe following sepsis.

People with black skin are more prone to scar and keloid formation. Scar formation can be prevented if the initial ear piercing is done under sterile conditions. If the puncture site is infected, skin is exposed to the metals of the ear stud. This can lead to reaction and scar formation.

It is difficult to treat the keloid by excision only. It needs a steriod injection to prevent recrurrence.

CHOLESTEATOMA IN PATIENTS WITH EAR DISCHARGE

CHOLESTEATOMA IN PATIENTS WITH EAR DISCHARGE

This picture shows two ear drums parall to each other. In the left ,a normal drum covered with normal skin is depicted. In the right , a skin pocket filled with dead cells seen towards the upper part of the drum. This is called cholesteatoma. This skin pocket can grow deeper within the bone causing harm to the structures it comes across.

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