External Ear

Painful rash of the auricle: Herpes zoster oticus

December 19, 2014     Chao-Yin Kuo, MD; Yuan-Yung Lin, MD; Chih-Hung Wang, MD, PhD
article

A PCR assay in addition to conventional serologic testing provides quick confirmation of the diagnosis of herpes zoster oticus infection.

Simultaneous non-Hodgkin lymphoma of the external auditory canal and thyroid gland: A case report

December 19, 2014     BeeLian Khaw, MD; Shailendra Sivalingam, MS-ORL; Sitra Siri Pathamanathan, MBBS; Teck S. Tan, MBChB, MRCS; Manimalar Naicker, MPath
article

Approximately 25% of all cases of extranodal non-Hodgkin lymphoma (NHL) occur in the head and neck region; NHL of the external auditory canal (EAC) and thyroid gland are rare. Specific immunohistochemical staining of the excised tissue is required to confirm the final pathologic diagnosis. We report the case of a 53-year-old woman with underlying systemic lupus erythematosus and autoimmune hemolytic anemia that were in remission. She presented with chronic left ear pain, a mass in the left EAC, and rapid growth of an anterior neck swelling that had led to left vocal fold palsy. High-resolution computed tomography (CT) of the temporal bone and CT of the neck detected a mass lateral to the left tympanic membrane and another mass in the anterior neck that had infiltrated the thyroid gland. The patient was diagnosed with simultaneous B-cell lymphoma of the left EAC and thyroid gland. She was treated with chemotherapy. She responded well to treatment and was lost to follow-up after 1 year. To the best of our knowledge, the simultaneous occurrence of a lymphoma in the EAC and the thyroid has not been previously described in the literature.

Cystic chondromalacia of the auricle treated with dual-plane excision with intracartilaginous dissection

September 17, 2014     Giovanni Zoccali, MD; Reza Pajand, MD; Nikolaos Vrentzos, MD; Maurizio Giuliani, MD
article

Abstract

Cystic chondromalacia of the auricle is an uncommon condition in which a degenerative process occurs within the cartilage. The disorder affects young and middle-aged people. Clinically, it manifests as a painless, fluctuant swelling that frequently relapses despite various therapeutic approaches. In this article we report a typical case of cystic chondromalacia of the auricle that was successfully treated by surgery-specifically, dual-plane dissection-and we briefly review the literature.

Angiolipoleiomyoma located in the earlobe

July 13, 2014     Sirin Yasar, MD; Zehra Asiran Serdar, MD; Fatih Goktay, MD; Burcu Barutcugil, MD; Selvinaz Ozkara, MD; Pelin Demirturk, MD
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Abstract

Angiolipoleiomyoma (ALLM) is a solid tumor that is mostly derived from muscle tissue. It is often located in the kidneys of patients with tuberous sclerosis; ALLMs located outside the kidneys are very rare. Among the rare presentations are cutaneous ALLMs, which manifest as 1- to 4-cm asymptomatic, acquired, solitary, subcutaneous nodules that have a strong predilection for males. To the best of our knowledge, only 22 cases of ALLM of the skin have been previously reported in the literature; in 5 of these cases, the tumor was located on the ear. Histologically, tumoral proliferation is observed with smooth muscle, fat tissue, and vascular channels surrounded by a fibrous capsule; cellular atypia is not observed. We report the case of a 67-year-old man who presented for evaluation of a purplish nodular lesion that had been present on his right earlobe for 10 years. Analysis of an excisional biopsy specimen revealed a nodular formation that consisted mostly of thick-walled veins within a fibromyxoid stroma; smooth-muscle tissue and fat globules were observed in places. The lesion was diagnosed as a cutaneous ALLM.

Chondroid syringoma of the ear lobule: A unique case

May 7, 2014     Yasser Al Omran, BSc (Hons); Rawia Mohamed, MBBS, FRCPA; Mohammed-Kamal Al-Omran, MBBS, FRCS Ed, FRCS (Glasg)
article

Because of the inconspicuous clinical presentation of chondroid syringomas, they are often disregarded; other, more common, differential diagnoses are usually considered.

Necrotizing fasciitis of the ear: An unusual case

March 18, 2014     Jessica L. Gullung, MD; Jacob E. Smith, MD; April D. Hendryx, DO; Krishna G. Patel, MD, PhD
article

Abstract

We describe a rare case of necrotizing fasciitis of the ear in an otherwise generally healthy 39-year-old man. The ear is rarely involved in this often-fatal disease. The diagnosis was suspected on the basis of clinical examination and confirmed by computed tomography and pathology of a biopsy specimen, which revealed subcutaneous gas formation and dermal infiltration of inflammatory cells, respectively. The patient was promptly treated with surgical debridement, intravenous antibiotics, and hyperbaric oxygen. He recovered well and subsequently underwent otoplastic reconstruction with very satisfactory results. By documenting this case, we aim to heighten awareness of necrotizing fasciitis of the head and neck in an effort to improve survival rates.

Nonmicroscopic reconstruction of subtotally amputated/torn auricles: Report of 3 cases

February 12, 2014     Shuaib K. Aremu, FWACS
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Abstract

Otolaryngologists are increasingly expected to perform a variety of minor surgical procedures in both elective and emergency situations. Surgical repair of the subtotally amputated/torn auricle, hitherto the realm of plastic surgeons, is a procedure that can be performed both at the clinic and in the emergency room, thereby sparing patients the inconvenience and cost of referral to another subspecialist. Presented in this article are 3 cases of traumatic tearing/amputation of the external ear: 1 caused by a motorbike accident, 1 caused by a human bite, and 1 by a machete. All three ears were successfully reconstructed nonmicrovascularly.

Basaloid squamous cell carcinoma of the pinna: Report of a rare case

January 21, 2014     Anil Jain, MS; Ashish Katarkar, MS; Pankaj Shah, MS; Jignasa Bhalodia, MD; Sanyogita Jain, MD; Sapna Katarkar, DA
article

Abstract

Basaloid squamous cell carcinoma (BSCC) is rare. We report a case of BSCC in a 60-year-old woman who presented with a bleeding vascular growth on the left pinna. To the best of our knowledge, no case of BSCC of the pinna has been previously reported in the literature. We present this case to alert physicians that this highly aggressive variant of squamous cell carcinoma can appear on the pinna and therefore it should be considered in the differential diagnosis of lesions in this area.

Using a capsule flap for the reconstruction of a partial auricular defect

July 21, 2013     Barsil Keklik, MD; Memet Yazar, MD; Karaca Basaran, MD; Erdem Guven, MD; Samet Vasfi Kuvat, MD
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Abstract

In this article we describe the capsular flap for covering the posterior surface of cartilaginous framework in ear reconstruction. This technique has not been previously described in the published literature.

Pressure ulcer of the pinna

June 11, 2013     Mainak Dutta, MS; Soumya Ghatak, MS; and Ramanuj Sinha, DLO, MS, DNB
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Pressure ulcers over the pinna usually develop as a result of local compression from oxygen mask tubing.

Pilomatricoma of the pinna

January 24, 2013     Aroor Rajeshwary, MS (ENT); Gangadhara Somayaji, MS (ENT); Sai Manohar, MS (ENT)
article

Abstract

A 4-year-old boy presented with a painless swelling over the right pinna of 4 months' duration. Histopathologic examination of the excised mass revealed features of pilomatricoma-a rare, benign skin neoplasm arising from hair follicle matrix cells. The unusual location of the lesion over the pinna, despite its frequent occurrence in the head and neck, prompted this article. We discuss the etiology, clinical presentation, and management of pilomatricoma of the auricular region

External auditory canal exostosis

January 24, 2013     Joseph A. Ursick, MD; Jose N. Fayad, MD
article

Exostoses, composed of immature layers of lamellar bone that cause a progressive stenosis of the external ear canal, are typically bilateral, occur at suture lines, and are associated with repeated exposure to cold water.