Furuncle of the external auditory meatus
The circumscribed form of otitis externa (otitis externa circumscripta) is inflammation localized in the cartilaginous part.
- Main sign: pronounced ear pain that sharply increases when pressing on the tragus.
- Localization feature: if the furuncle is located on the anterior wall, chewing movements also cause pain due to proximity to the temporomandibular joint.
- Complications: regional lymph nodes become inflamed, and the process can spread to the parotid gland through the cartilaginous incisures.
Diagnostics and anatomical features
The external ear consists of the auricle (auricula) and the auditory meatus.
- In infants, the auditory meatus is short and lacks a bony part, so pressure on the tragus is transmitted to the tympanic membrane, causing pain in acute otitis media.
- The anatomical structure of the auricle (helix, tragus, antitragus) is important for accurate topical diagnosis of pathologies.
- Skin and cartilage lesions require consideration of individual structure and susceptibility to frostbite.
Treatment of otitis externa and furuncle
Treatment tactics depend on the form and severity of the inflammatory process:
- Diffuse otitis externa: irrigation of the meatus, removal of pus, desensitizing therapy, and the use of ointments (chloramphenicol, polymyxin ointment for Pseudomonas aeruginosa).
- Furuncle: systemic prescription of penicillin and cephalosporin antibiotics, local ointments (levomekol, yellow mercuric oxide).
- Surgical intervention: opening of the furuncle is performed in case of severe pain, abscess formation, or a protracted spontaneous process.
- Physiotherapy: UV irradiation of the auditory meatus via a speculum and UHF therapy.
Otomycosis and tuberculosis of the ear
- Otomycosis: fungal infection of the external ear that develops gradually as the mycelium penetrates deeper into the skin. Accompanied by itching, pain, stuffiness, and scanty discharge.
- Tuberculosis of the ear: a rare disease occurring against the background of pulmonary tuberculosis. Characterized by the formation of tubercles in the tympanic membrane, their breakdown with multiple perforations, foul-smelling discharge, and the risk of temporal bone osteonecrosis.
Press the tragus — get pain: in adults, expect otitis externa; in infants, otitis media!
Class and exam questions
Why does ear pain increase during chewing?
This occurs when a furuncle is localized on the anterior wall of the auditory meatus, as it borders the temporomandibular joint and shifts during jaw movement.
How does pain upon pressing the tragus differ between adults and children?
In adults, this indicates inflammation of the external auditory meatus, while in infants, it indicates acute otitis media due to anatomical features and a short auditory meatus.
How does tuberculous involvement of the ear manifest?
It usually begins painlessly, with the appearance of multiple perforations in the tympanic membrane that merge, leading to profuse purulent discharge and the risk of bone destruction.
What else to study on this topic
- Clinical anatomy and physiology of the auricle
- Physiotherapy methods for ear inflammation
- Differential diagnosis of middle ear tuberculosis
- Types and purposes of diagnostic bronchoscopy
- General and local therapy for laryngeal tuberculosis
Master the complete topic in the «Infectious Diseases» course
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