Partial medial canal fibrosis.A 31-year-old woman presented with chronic drainage from the left ear. Her condition had not resolved with oral and topical antibiotics Antibiotics, Topical Definition Topical antibiotics are medicines applied to the skin to kill bacteria. Purpose Topical antibiotics help prevent infections caused by bacteria that get into minor cuts, scrapes, and burns. . The otoscopic appearance of the left eardrum ear·drum n. The thin, semitransparent, oval-shaped membrane that separates the middle ear from the external ear. Also called drum, drumhead, drum membrane, myringa, myrinx, tympanic membrane, was similar to that seen in a case of tympanic membrane perforation tympanic membrane perforation Perforated, punctured, ruptured ear drum ENT A disruption of the tympanic membrane due to acoustic trauma, direct injury, barotrauma, introduction of Q-tips or small objects, or infection with fluid buildup in the middle ear. See Tympanoplasty. , but the pathology was much more lateral and the eardrum could be visualized through the circumferential fibrotic tissue involving the ear canal (figure 1). Findings on audiometry and tympanometry of the left ear were normal. Computed tomography (CT) of the temporal bone demonstrated the fibrotic tissue band lateral to the tympanic membrane (figure 2). The patient underwent surgery, the fibrotic tissue was removed, and a canaloplasty was performed. [FIGURES 1-2 OMITTED] Medial canal fibrosis is more common in females than males, and it may be seen at any age. Among the causative factors that have been implicated im·pli·cate tr.v. im·pli·cat·ed, im·pli·cat·ing, im·pli·cates 1. To involve or connect intimately or incriminatingly: evidence that implicates others in the plot. 2. are chronic infection, hearing aid use, and surgical trauma. Over time, chronic inflammation leads to the formation of granulation tissue in the ear canal, and the granulation granulation /gran·u·la·tion/ (-shun) 1. the division of a hard substance into small particles. 2. the formation in wounds of small, rounded masses of tissue during healing; also the mass so formed. eventually matures into dense fibrotic tissue. A careful physical examination is of utmost importance in establishing the diagnosis. In patients with complete medial canal fibrosis, the external ear canal appears to be shortened by a skin-covered barrier that may resemble a lateralized tympanic membrane. Findings on the physical examination will vary according to the degree of severity in cases of partial fibrosis. CT is useful for evaluating the extent of the pathology. Suggested reading Birman CS, Fagan PA. Medial canal stenosis--Chronic stenosing external otitis otitis Inflammation of the ear. Otitis externa is dermatitis, usually bacterial, of the auditory canal and sometimes the external ear. It can cause a foul discharge, pain, fever, and sporadic deafness. . Am J Otol 1996:17:2-6. el-Sayed Y. Acquired medial canal fibrosis. J Laryngol Otol 1998:112: 145-9. Slattery WH III, Saadat R Postinflammatory medial canal fibrosis. Am J Otol 1997:18:294-7. Adrien A. Eshraghi, MD; S. Arif Ulubil, MD From the University of Miami This article is about the university in Coral Gables, Florida. For the university in Oxford, Ohio, see Miami University. The University of Miami (also known as Miami of Florida,[2] UM,[3] or just The U Ear Institute, Department of Otolaryngology, University of Miami Miller School of Medicine. |
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