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The cytology of the external ear canal in the normal dog and cat.

This study was conducted on 50 normal dogs and 52 normal cats in order to characterize the normal cytological findings in specimens taken from the vertical ear canal by swabbing. Yeast were detected in 96% of the dogs and 83% of the cats. Gram-positive cocci were found in 42% of the dogs and 71% of the cats. Rods were not seen. In dogs, the median numbers per high-power microscopic field (400x magnification) for yeast, cocci and keratinocytes were 0.2, 0 and 3.9, respectively. In cats, the median numbers were 0.2, 0.3 and 8, respectively. Nucleated keratinocytes were occasionally observed in both species, and should not be mistaken for a pathological process (parakeratotic hyperkeratosis).

Animals↗

Nodular fasciitis of the external ear region: a clinicopathologic study of 50 cases.

Nodular fasciitis (NF), uncommon in the auricular area, is a benign reactive myofibroblastic proliferation that may be mistaken for a neoplastic proliferation. Fifty cases of NF of the auricular region were identified in the files of the Otorhinolaryngic-Head and Neck Tumor Registry of the Armed Forces Institute of Pathology. The patients included 22 females and 28 males, aged 1 to 76 years (mean, 27.4 years). The patients usually presented clinically with a mass lesion (n = 49). Five patients recalled antecedent trauma. The lesions were dermal (n = 28) or subcutaneous (n = 11) in those cases where histologic determination was possible, measuring 1.9 cm on average. The majority of the lesions were circumscribed (n = 38), composed of spindle-shaped to stellate myofibroblasts arranged in a storiform growth pattern, juxtaposed to hypocellular myxoid tissue-culture-like areas with extravasation of erythrocytes. Dense, keloid-like collagen and occasional giant cells were seen (n = 18). Mitotic figures (without atypical forms) were readily identifiable. By immunohistochemical staining, myofibroblasts were reactive with vimentin, actins, and CD68. All patients had surgical excision. Four patients (9.3%) developed local recurrence and were alive and disease free at last follow-up. All patients with follow-up (n = 43) were alive or had died of unrelated causes, without evidence of disease an average 13.4 years after diagnosis. Nodular fasciitis of the auricular area occurs most often in young patients. Because NF is more often dermally situated than extremity NF, it may present with superficial ulceration and/or bleeding. Local recurrence is more frequent because of the difficulty in obtaining complete surgical excision around the ear.

Adolescent↗

Acute renal failure in a healthy young adult after dextran 40 infusion for external-ear reattachment surgery.

Dextran 40 is used to improve the microcirculation after certain surgical procedures. We report a rare case of acute anuric renal failure in a healthy young adult after administration of dextran 40 to improve the microcirculation following ear-reattachment surgery. The renal failure was subsequently reversed by plasmapheresis and intensive care support. Although rare in the young and fit, the risk of developing acute anuric renal failure exists with administration of dextran 40 and appropriate monitoring is essential.

Acute Kidney Injury↗

[Psychosocial aspects in total external ear reconstruction in patients with severe microtia].

BACKGROUND: The aim of this study was to identify the psychosocial problems and expectation of patients with severe microtia and to investigate possible changes in psychosocial profile of patients after surgical reconstruction of the pinna. METHODS: Interviews were performed with 65 patients before and 39 patients after auricular reconstruction. They consisted of a questionnaire involving open and closed questions relating to the reconstruction and a personality test. RESULTS: The most frequently mentioned reasons for surgery were: personal dissatisfaction with patients own appearance, lack of self-confidence, and for younger age groups, parental anxiety about the future psychosocial development of their children. More than 90% of the patients with surgically reconstructed auricles were satisfied with the postoperative results and showed a more open and fearless personality profile. CONCLUSIONS: Auricular reconstruction enhances the development of a stable personality.

Adolescent↗

[Postoperative pain therapy using on-demand analgesia after external ear reconstruction with rib cartilage harvesting].

BACKGROUND: The individual experience of postoperative pain values considerably. It is the patient who can best evaluate the intensity of pain and the effect of a given analgesic substance. Patient-controlled analgesia (PCA) enables the patient to self-administer an i.v. analgesic bolus by pressing a button of an electronic pump device within a previously set range. If needed. The resection of rib cartilage to be used for ear reconstructions is associated with intense postoperative pain. This could result in unfavorable stress responses such as impaired cough and clearance of lung secretions carrying a greater risk of bronchitis or pneumonia, prolonged mobilization, and complications of wound healing. Therefore, individually adapted pain therapy is of great importance and technically feasible with modern PCA devices. METHOD: Informed and cooperative children aged five years and older and adults without severe health risks are suitable for PCA. Management, handling, monitoring and documentation of the PCA device are discussed. A 24-hour counselling service is maintained for occurring problems. RESULTS: Almost all patients expressed their great satisfaction with the means of pain therapy. Few patients were apprehensive. The initial scepticism of the involved personnel concerning opioid abuse, over-dosage, or technical problems gave way for a support of the PCA once the great satisfaction of the patients in absence of side effects was witnessed. No patient had to be antagonized for respiratory depression. Nausea and vomiting were rare events. CONCLUSION: Patient-controlled analgesia proved to be an excellent answer to postoperative pain after resections of rib cartilage.

Adult↗

[Photodynamic laser tumor therapy with a hematoporphyrin derivative in spinocellular carcinoma of the external ear].

Haematoporphyrine-derivative (hpd) selectively photosensitises malignant tumours following intravenous application. 48 hours after injection of hpd an integral laser-light application of the tumour and the surrounding normal tissue was performed. We report on the successful administration of this photodynamic therapy in a patient with a spinocellular carcinoma of the auricle. 16 days after therapy the tumour showed a complete response without damage of the also irradiated surrounding normal tissue. Apart from a temporary sensitivity to light no side effects of the therapy were seen.

Carcinoma, Squamous Cell↗

[Recurrent episcleritis with hyperemia of the external ear As an early symptom of chronic polychondritis].

A 49-year-old patient with relapsing polychondritis, who presented in the first instance to an eye department, is described. The patient had episcleritis, papilloedema and posterior scleritis. Both auricles were red, swollen and tender under pressure. The patient responded well to systemic steroid therapy for two weeks. Relapsing polychondritis is a rare connective tissue disorder. Early diagnosis is important, as progressive disease may cause lesions of vital organs (lung, heart).

Cartilage Diseases↗

The pathology of the external ear canal in dogs and cats.

A survey of factors which predispose the canine ear to otitis externa is presented. In resected ear specimens of 106 dogs, otitis externa without tumour was found on 58 occasions. In 46 dogs tumours were diagnosed in 15 cases with an otitis externa. In two dogs an inflammatory polyp was found. In the resected ear specimens of 48 cats, otitis externa was diagnosed 27 times, in 6 cases combined with an inflammatory polyp. In 21 cases neoplasia was present. The otitis externa was mainly a chronic proliferative inflammation characterised by hyperkeratinization, hyperplasia of the sebaceous and ceruminous glands, fibrosis and infiltration with plasma cells, lymphocytes and macrophages, often containing ceroid pigment.

Animals↗

Postoperative protection for the external ear.

The postoperative dressing is an integral part of an otoplasty. The dressing should fit securely, provide protection, and be comfortable for the patient to wear. Wrestling headgear can be used to fill these needs.

Ear Protective Devices↗