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Pseudocyst of the auricle, also known as auricular pseudocyst, endochondral pseudocyst, cystic chondromalacia, intracartilaginous auricular seroma cyst, and benign idiopathic cystic chondromalacia, [1] is a cutaneous condition characterized by a fluctuant, tense, noninflammatory swelling on the upper half of the ear, known as the auricle or pinna.
Chondrodermatitis nodularis chronica helicis (CNCH) is a small, nodular, tender, chronic inflammatory lesion occurring on the helix of the ear, most often in men. [2]: 610 it often presents as a benign painful erythematous nodule fixed to the cartilage of the helix or antihelix of the external ear. [3]
A cauliflower ear deformity. Inflammation of the cartilage of the ear is a specific symptom of the disease and affects most people. [3] It is present in about 20% of persons with RP at presentation and in 90% at some point. [3] Both ears are often affected but the inflammation may alternate between either ear during a relapse. [3]
Each involves the external ear. The difference between them is that a cyst does not connect with the skin, but a sinus does. [3] Frequency of preauricular sinus differs depending the population: 0.1–0.9% in the US, 0.9% in the UK, and 4–10% in Asia and parts of Africa. [4]
The symptoms are occipital headache, cough, middle ear effusion, cervical myalgia, and halitosis, i.e. bad breath. When there is an enlargement of the cyst, it causes symptoms like nasal obstruction, post-nasal discharge with foul-smelling odour, blockage of the Eustachian tube causing otalgia and secretory otitis media, retro-orbital pain.
Secondary ear pain is a type of referred pain, meaning that the source of the pain differs from the location where the pain is felt. Primary ear pain is more common in children, whereas secondary (referred) pain is more common in adults. [13] Primary ear pain is most commonly caused by infection or injury to one of the parts of the ear. [3]
Not all middle ear epidermal cysts are congenital, as they can be acquired either by metaplasia of the middle ear mucosa or by traumatic implantation of ear canal or tympanic membrane skin. In addition, cholesteatoma inadvertently left by a surgeon usually regrows as an epidermal cyst. Some authors have also suggested hereditary factors. [9] [10]
Canaloplasty, where the ear canal is widened using grafts, was first proposed as the treatment for keratois obturans. However, with the migration of keratin within the canal, any amount of widening could not restore the migration of skin. Reconstruction of the bony canal with cartilage graft from temporalis fascia has showed some results. [6]