Congenital Deformities   ^top

There are many types of deformity that can occur. The most common deformity is the protruding ear of “Lop Ear”. There can be absence of (or near absence of) any ear development called Microtia. This can be associated with failure in development of an ear canal. All of these deformities can be repaired surgically. The protruding ear is the easiest to correct by a procedure called otoplasty. Changes are made to give the ear a more natural shape and position so attention is not drawn to them. Microtia repair can be very complicated, and take several staged operations to correct.

Ear Trauma   ^top

External Ear Trauma

Blunt trauma to the external ear may cause a blood clot to form under the skin. If the clot is not drained new cartilage will case a gnarling and bulging deformity of the ear called a wrestler’s ear or cauliflower ear. Lacerations to the ear can be repaired by stitching torn cartilage and skin back in place. Sometimes parts that are amputated can be saved and repaired. Any severed part should be wrapped in a moist towel or gauze, put in a clean plastic bag and packed in ice to accompany the patient to the emergency room. Parts that are lost can be reconstructed by taking skin and cartilage from other parts of the body. Complex repairs sometimes require multiple staged operations.

Inner Ear Trauma

Fractures to the skull bone that houses the ear (temporal bone) can result in damage to the middle ear bones or nerves of the inner ear resulting in hearing loss. The facial nerve can also be damaged causing paralysis of the face. At times spinal fluid can leak from around the brain out the ear canal or down the eustachian tube after this type of fracture. Surgery can correct some of these problems caused by temporal bone fractures.

Eardrum Perforations   ^top

Ear Drum perforations usually result from injury or infection. The most common injuries causing perforations are a slap in the ear or trauma from water skiing or diving. These perforations frequently heal spontaneously in one or two months. Perforations caused by chronic infections usually do not heal. They can be small or large. They are usually associated with some degree of hearing loss. They can be repaired by a surgical procedure called Tympanoplasty. It is important to keep water out of an ear with a perforation as water can carry in bacteria and cause infection. Mucous draining from an ear with a perforation is always a sign of infection, and needs to be treated.

Infections   ^top

Middle ear infections are much more common in children than adults. Children who start with frequent infections in infancy frequently outgrow the problem around age two. Children who have frequent infections after age two usually have allergies or adenoid problems causing the infections. If allergies or adenoids are not the cause there is a Eustachian tube dysfunction, and most of these children will out grow the infections at around age eight to nine. Fever, pain, and irritability are the main symptoms of middle ear infections. Pain is usually worse when lying down at night, and causes frequent awakenings. Antibiotics usually completely clear the infection, but when they do not solve an infection, or when the infections recur very often the insertion of ventilation tubes into the eardrums usually helps. The tubes bypass the eustachian tube allowing air into the middle ear. This prevents a vacuum from forming when there is swelling with colds, allergies, etc., and allows the natural fluids in the middle ear to drain down the eustachian tube. These fluids contain antibodies that kill bacteria and viruses that are trying to migrate up the tube into the middle ear, and as long as these fluids can continue to drain from the middle ear to the nasopharynx (via the eustachian tube) bacteria and viruses have a difficult time reaching the middle ear.

Swimmer's Ear   ^top

Swimmer’s Ear is an infection of the skin of the ear canal. Moisture in the ear canal creates an environment favorable for the growth of bacteria and fungus. The symptoms of this infection are pain and tenderness to touch the ear. At times this can be extremely painful. Antibiotic drops usually clear the infection, but at times if there is severe swelling of the ear canal a wick has to be inserted to draw the drops into the canal. Frequently the ear must be cleaned by an ear specialist to help the medications to work and resolve the infection more quickly.

Tubes   ^top

See Infections

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