Malignant melanoma of the external ear. Report of 36 cases treated between 1928-1944.
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We have used the porous polyethylene, pivoting helix framework for ear reconstruction at RLAMC since 1989 with no major complications. Postoperatively, patients have an external ear that resembles a normal ear and is sturdy enough to support eye wear. The aesthetic results have been well received by the patients and their families (Fig 8). Most children are reluctant to undergo surgery; however, those patients with ear deformities often are eager for external ear reconstruction surgery, and the majority of our pediatric patients have been pleased with the postoperative results (Fig 9). The success of this procedure depends on a number of factors, including proper patient selection, suitable selection of materials for the reconstruction, the technical skills of the surgeon, and the surgical team's attention to detail in the intraoperative period. The perioperative nurse, functioning as the patient advocate, plays an integral role in the success or failure of this procedure.
Medicament contact dermatitis can be troublesome in external ear disease. In this work the effects on the guinea pig external ear of instillation twice daily for 3 weeks of benzalkonium chloride, Cerumol, gentamicin, the pharmaceutical base for Gentisone HC, hydrocortisone and propylene glycol were studied using light microscopy, thickness measurements of tympanic membrane and meatal epidermis, and the mitotic index of meatal epidermis. Benzalkonium chloride induced severe inflammatory changes and markedly increased the thickness measurements and meatal mitotic index. Cerumol also increased the thickness measurements and the mitotic index; there was additionally low grade chronic inflammation in the dermis. Prophylene glycol increased the mitotic index and thickness measurements though no signs of inflammation were seen. Other compounds did not produce significant changes except that hydrocortisone reduced the mitotic index. Contact dermatitis to benzalkonium chloride may be important in persistent ear disease. Cerumenolytic agents ought not to be used for prolonged periods or as prophylaxis.
Echolocating bats (Eptesicus fuscus) can perceive changes of as little as 3 degrees of arc in the vertical angles separating pairs of horizontal rods. This acuity depends upon modification of sounds entering the external ear canal by the structures of the external ear. Deflection of the tragus degrades the acuity of vertical-angle perception from 3 degrees to about 12 degrees to 14 degrees. The pinna-tragus structure produces a strong secondary echo of sounds entering the external ear canal, and the delay of this echo after the time when the sound directly enters the ear canal apparently encodes the vertical direction of a sound source.
Two families are presented in which affected members had deafness, preauricular sinuses, branchial fistulae and malformation of the external ear. In Family I, a renal abnormality was an associated feature. In Family 2, two individuals had an abnormality of the incudostapedial joint. In both families inheritance was autosomal dominant with variable expressivity. The occurrence of external-ear malformations, branchial fistulae, and preauricular sinuses should indicate the need to search for a hearing loss not only in the patient but amongst relatives.
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