Clinical Cases in Otolaryngology Nirmal Kumar Soni, Lokesh Kumar Bhama
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Chapter Notes

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1Diseases of the Ear
  • → Microtia
  • → Preauricular Sinus
  • → Preauricular Appendages (Accessory Auricular Tags)
  • → Cauliflower Ear
  • → Keloid Ear Lobule
  • → Exostoses (Diaphyseal Aclasis)
  • → Osteoma
  • → Otomycosis (Otomycotic Disease)
  • → Traumatic Perforations of the Tympanic Membrane
  • → Secretory Otitis Media
  • → Chronic Suppurative Otitis Media
  • → Chronic Suppurative Otitis Media with Atticoantral Disease
  • → Chronic Suppurative Otitis Media with Ear Polyp
  • → Multiple Perforations of the Tympanic Membrane
  • → Bell's Palsy
  • → Glomus Tumors2

MicrotiaCASE 1

CASE: A malformed small-sized pinna.
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Fig. 1: Microtia (right)
 
 
Provisional Diagnosis: Microtia
Q.1 How does a malformed pinna develop?
Ans. The auricle develops from the six hillocks of His. Maldevelopment or failure of fusion can result in gross abnormalities of the ear. Microtia is a deformed small-sized pinna (Fig. 1). It may or may not be associated with middle or inner ear abnormalities.
Q.2 What is the classification of congenital malformed pinna?
Ans.
  1. Grade I: Normal ear.
  2. Grade II: All pinna elements present but malformed.
  3. Grade III: Rudementary bar only.
  4. Grade IV: Absent pinna (Anotia).
Q.3 What are the investigations to be done in malformed pinna?
4Ans.
  1. Documenting the defect.
  2. Examining the external auditory canal (for associated abnormalities).
  3. Hearing assessment.
  4. CT scan (to assess middle ear, ossicles or cochlear anatomy).
Q.4 What is the treatment?
Ans. The treatment depends on type and severity of abnormalities:
  1. Minor abnormalities (grade II): No treatment is required.
  2. Major deformity (grades III and IV anotia):
    • Removal of rudimentary pinna
    • Bone anchored hearing aid (BAHA)
    • Abutment to attach an artificial pinna
    • Plastic reconstruction of pinna (if possible).