![]() EECC presents itself by an accumulation of epithelial debris in the ear canal, and early reports on such manifestations have been made in 1850 by Toynbee and later in 1893 by Scholefield. Whereas the aetiology of secondary EECC can be explained, the origin of primary EECC remains uncertain smoking and minor trauma of the ear canal may predispose.Įxternal ear canal cholesteatoma (EECC) is a rare condition with an estimated incidence of 1.2 per 1,000 new otological patients. Otalgia was the predominant symptom and often related to extension into nearby structures. ![]() ConclusionĮECC is a rare condition with inconsistent and silent symptoms, whereas the extent of destruction may be pronounced. ![]() In primary EECC 48% of cases reported mechanical trauma. In one primary case the facial nerve was exposed and in a posttraumatic case the atticus and antrum were invaded. In total the temporomandibular joint was exposed in 11 cases, while the mastoid and middle ear was invaded in six and three cases, respectively. Similar symptoms were found in secondary EECC, but less pronounced. Primary EECC showed a right/left ratio of 12/13 and presented with otalgia (n = 15), itching (n = 5), occlusion (n = 4), hearing loss (n = 3), fullness (n = 2), and otorrhea (n = 1). Twenty-five cases were primary, while 23 cases were secondary: postoperative (n = 9), postinflammatory (n = 5), postirradiatory (n = 7), and posttraumatic (n = 2). Overall incidence rate was 0.30 cases per year per 100,000 inhabitants. Resultsįorty-five patients were identified with 48 EECC. Main outcome measures were incidence rates, classification according to causes, symptoms, extensions in the ear canal including adjacent structures, and possible etiological factors. Retrospective evaluation of clinical records of all consecutive patients with EECC in the period 1979 to 2005 in a tertiary referral centre. The lymphatic drainage of the external ear is to the superficial parotid, mastoid, upper deep cervical and superficial cervical nodes.To evaluate symptoms, clinical findings, and etiological factors in external ear canal cholesteatoma (EECC). Some individuals can complain of an involuntary cough when cleaning their ears - this is due to stimulation of the auricular branch of the vagus nerve (the vagus nerve is also responsible for the cough reflex). Branches of the facial and vagus nerves - innervates the deeper aspect of the auricle and external auditory meatus.Auriculotemporal nerve (branch of the mandibular nerve) - innervates the skin of the auricle and external auditory meatus.Lesser occipital nerve (branch of the cervical plexus) - innervates the skin of the auricle.Greater auricular nerve (branch of the cervical plexus) - innervates the skin of the auricle.The sensory innervation to the skin of the auricle comes from numerous nerves: Venous drainage is via veins following the arteries listed above. Maxillary artery (deep auricular branch) - supplies the deep aspect of the external acoustic meatus and tympanic membrane only.The external ear is supplied by branches of the external carotid artery: The parts of the tympanic membrane moving away from the lateral process are called the anterior and posterior malleolar folds. The handle of malleus continues superiorly, and at its highest point, a small projection called the lateral process of the malleus can be seen. On the inner surface of the membrane, the handle of malleus attaches to the tympanic membrane, at a point called the umbo of tympanic membrane. The translucency of the tympanic membrane allows the structures within the middle ear to be observed during otoscopy. The membrane is connected to the surrounding temporal bone by a fibrocartilaginous ring. It is a connective tissue structure, covered with skin on the outside and a mucous membrane on the inside. The tympanic membrane lies at the distal end of the external acoustic meatus. It ends by running in an inferoanterior direction.In then turns slightly to move superoposteriorly.Initially it travels in a superoanterior direction.The external acoustic meatus does not have a straight path, and instead travels in an S-shaped curve as follows: ![]() The walls of the external 1/3 are formed by cartilage, whereas the inner 2/3 are formed by the temporal bone. The external acoustic meatus is a sigmoid shaped tube that extends from the deep part of the concha to the tympanic membrane. ![]()
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