Polyp in the external auditory canal

Polyps are a very special disease that can appear in many parts of the body, such as nasal polyps, gastric polyps, uterine polyps, etc. Polyps in the external auditory canal may not be polyps, but granulations in the external auditory canal. Most granulations develop from lesions in the middle ear and are related to middle ear cholesteatoma and otitis media. You can learn about these two diseases and make a comprehensive judgment based on your own situation.

Clinical manifestations of middle ear cholesteatoma

Clinically, it is characterized by long-term pus discharge in the ear, tympanic membrane perforation and hearing loss. The patient has a long medical history, with long-term or intermittent pus discharge from the ear canal with a peculiar foul odor.

Clinical manifestations of otitis media

1. Suppurative otitis media

(1) Acute suppurative otitis media is an inflammation of the middle ear caused by suppurative bacterial infection, with the main symptoms being ear pain and pus discharge. Children's systemic symptoms are more obvious than those in adults, and may include fever, vomiting, etc. Serious complications include intracranial complications such as meningitis, brain abscess, etc. Other complications include labyrinthitis, facial nerve paralysis, etc.

(2) Chronic suppurative otitis media refers to chronic suppurative inflammation of the middle ear mucosa, periosteum or deep into the bone. This disease is relatively common in clinical practice, and its main clinical manifestations are intermittent or continuous pus discharge in the ear, tympanic membrane perforation, and hearing loss. In severe cases, it can cause intracranial and extracranial complications. ① Systemic symptoms vary in severity. There may be fear of cold, fever, fatigue, and loss of appetite. Children have more severe systemic symptoms, often accompanied by gastrointestinal symptoms such as vomiting and diarrhea. Once the eardrum is perforated, the body temperature will gradually drop and systemic symptoms will be significantly alleviated. ② Earache: Pain deep in the ear that gradually worsens. Such as throbbing or stabbing pain, which may radiate to the same side of the head or teeth. Ear pain worsens when swallowing and coughing. Severe ear pain can cause insomnia and restlessness at night. After the eardrum perforated and pus flowed out, the ear pain suddenly subsided. ③ Ear discharge is the main symptom of this disease, which can be mucous, mucopurulent or pure purulent. Non-dangerous pus discharge is thinner and has no odor. Although the dangerous type of pus discharge is not much, it is thicker, mostly pure purulent, and accompanied by a foul odor. ④ Hearing loss and tinnitus: The patient begins to feel stuffy in the ears, followed by a gradual decrease in hearing, accompanied by tinnitus. Deafness may be ignored in patients with severe ear pain. Some patients may experience vertigo, and deafness may be alleviated after perforation. ⑤ The severity of deafness varies, and because it usually occurs in one ear, it is easily overlooked. It is usually conductive hearing loss.

2. Non-suppurative otitis media and secretory otitis media.

(1) Hearing loss Acute secretory otitis media can often cause hearing loss after a cold, while descending on an airplane, or while diving, and may also be accompanied by a "self-enhanced sound" phenomenon. The severity of hearing loss in patients with chronic secretory otitis media often fluctuates. Hearing may improve when the tragus is compressed or the head position is changed. When the middle ear fluid is thick, hearing will not change with changes in head position. Most children do not complain of hearing loss, but may ignore their parents' calls, have difficulty concentrating, or request too loud a volume when watching TV.

(2) Earache: Mild earache may occur in acute secretory otitis media, while earache may occur in chronic secretory otitis media when secondary infection occurs.

(3) A feeling of stuffiness or blockage in the ear.

(4) Tinnitus is usually not severe and may be intermittent. The sound of air passing through water may be heard when the head moves, yawns, or blows the nose. A small number of patients with secretory otitis media may also experience water discharge in the ears, but the duration is very short, only a few hours or about a day.

(5) Otoscopic examination reveals radial vascular patterns around the tympanic membrane in the acute phase. The tense part of the tympanic membrane is indented, manifested by shortening, deformation or disappearance of the light cone; the handle of the malleus is displaced backward and upward; and the short process of the malleus protrudes significantly outward. When fluid accumulates in the tympanic cavity, the tympanic membrane loses its normal luster and becomes light yellow, orange-red or amber. In chronic cases, the tympanic membrane becomes milky white or gray-blue and opaque. If the secretion is serous and does not fill the tympanic cavity, the liquid level can be seen through the tympanic membrane as an arc-shaped line with a concave surface upward. Air bubbles can sometimes be seen through the tympanic membrane, and the number of bubbles increases after the Eustachian tube is expanded. If there is a lot of fluid in the tympanic cavity, the tympanic membrane will protrude and the mobility of the tympanic membrane will be limited.